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ESO MIM 2017-2018
Musician's or Ensemble's Name *
(will be printed on signage)
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Contact Name *
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Contact Email Address *
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Contact Phone Number *
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Instrument(s) *
(Note that we cannot provide amplification)
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If performing with others (i.e. accompanist), list each performer and his/her instrument here:
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Total Number of Performers *
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Teacher Name and Contact Information
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Music School
(If applicable)
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1st Choice of Available Performance Dates *
(please see list of available dates)
MM
/
DD
/
YYYY
2nd Choice of Available Performance Dates *
(please see list of available dates)
MM
/
DD
/
YYYY
3rd Choice of Available Performance Dates *
(please see list of available dates)
MM
/
DD
/
YYYY
Will You Require a Piano & Bench? *
How Many Music Stands Will You Need? *
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How Many Armless Chairs Will You Need? *
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Additional Comments
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In 2-3 sentences, please describe your background, skills and/or experience. *
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