EUROASIA VIOLIN COMPETITION

APPLICATION FORM
Application Deadline: 31st May 2015

PARTICIPANT DETAILS:
Full Name:

__________

Date of Birth:

Age as at 1st June, 2015: _______________________

Nationality: ___________________________________________ I/C No:___________________________________________

Email Address: _______________________________________ Contact No:______________________________________
For participants under 18 years of age:
Parents Name:

__________

Contact Email :

__________

Contact Phone Number:

REGION

_____________________________

Johor Bahru

Kuala Lumpur

Kuantan

Kuching

Penang

Seremban

OPEN CATEGORY

Novice [RM120]

Junior [RM140]

Youth

Senior [RM200]

[RM170]

Repertoire
________________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________Piece

Duration: ____________________________

YOUNG ARTIST
Junior [RM300]

Youth [RM300]

Senior [RM300]

Preliminary Repertoire
_______________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________ Programme Duration:

___________________

Final Round Chosen Works: Please include title of pieces and composer.
(Own choice of programme not exceeding 15 minutes, including at least two works from two different periods.)
______________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________ Programme Duration:

__________________

FEES PAYABLE [A] OPEN

RM _________________

[B] YOUNG ARTIST RM _________________

TOTAL: RM ______________________

Fees are payable by online transfer or direct deposit (cash/cheque).

- For payments made via online transfer, please submit competition@euroasia.org.my
as the email notification address.
- For direct deposit payments, please state the applicant name on the transaction, and
email us (competition@euroasia.org.my) a copy of the transaction slip.
Account Name:
Account Number:
Bank Name:
SWIFT CODE:

EUROASIA ASSOCIATION OF PERFORMING ARTS

8007-3603-73
CIMB Bank Berhad (13491-P)
CIBBMYKL

By submitting this Application Form, the applicant is deemed to agree and comply with this
document and will be fully responsible for the fees above.
Please ensure that full payment is made within 3 days to confirm your application.

OPTIONAL:
Teachers Name:

________

Teachers contact phone number:

________