2016 KMTA ALL-STATE PIANO ENSEMBLE REGISTRATION FORM

DEADLINE AUGUST 1, 2016

Teacher’s Name: ______T- Shirt size______

Address: ______City/State/Zip____________

Phone:Home______Work_________e-mail______

ARE YOU WILLING TO PLAY IN A TEACHER ENSEMBEL? ______

On the lines below list each student's name, grade in school and years of piano study. If this is the first year for a student to participate, list one piece recently performed by the student that represents level of reading ability.If student has participated previously in the KMTA All-State Ensemble, list how many years in All-State including the present year.

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*STUDENT NAME: ____________SCHOOL GRADE:______YEARS OF PIANO STUDY______

PARTICIPATED MOST RECENTLY IN (YEAR) ______Where do you prefer placement this year? (CIRCLE GROUP) A B C D E

IF A FIRST TIME PARTICIPANT LIST ONE PIECE THAT REPRESENTS STUDENT LEVEL OF PERFORMANCE AND WE’LL PLACE THEM IN THE APPROPRIATE GROUP: Title:______Composer: ______T-shirt size ______TOTAL YRS.PARTCIPATED:_____

*STUDENT NAME: ____________SCHOOL GRADE:______YEARS OF PIANO STUDY______

PARTICIPATED MOST RECENTLY IN (YEAR) ______Where do you prefer placement this year? (CIRCLE GROUP) A B C D E

IF A FIRST TIME PARTICIPANT LIST ONE PIECE THAT REPRESENTS STUDENT LEVEL OF PERFORMANCE AND WE’LL PLACE THEM IN THE APPROPRIATE GROUP: Title:______Composer: ______T-shirt size ______TOTAL YRS.PARTCIPATED:_____

*STUDENT NAME: ____________SCHOOL GRADE:______YEARS OF PIANO STUDY______

PARTICIPATED MOST RECENTLY IN (YEAR) ______Where do you prefer placement this year? (CIRCLE GROUP) A B C D E

IF A FIRST TIME PARTICIPANT LIST ONE PIECE THAT REPRESENTS STUDENT LEVEL OF PERFORMANCE AND WE’LL PLACE THEM IN THE APPROPRIATE GROUP: Title:______Composer: ______T-shirt size ______TOTAL YRS.PARTCIPATED:_____

*STUDENT NAME: ____________SCHOOL GRADE:______YEARS OF PIANO STUDY______

PARTICIPATED MOST RECENTLY IN (YEAR) ______Where do you prefer placement this year? (CIRCLE GROUP) A B C D E

IF A FIRST TIME PARTICIPANT LIST ONE PIECE THAT REPRESENTS STUDENT LEVEL OF PERFORMANCE AND WE’LL PLACE THEM IN THE APPROPRIATE GROUP: Title:______Composer: ______T-shirt size ______TOTAL YRS.PARTCIPATED:_____

*STUDENT NAME: ____________SCHOOL GRADE:______YEARS OF PIANO STUDY______

PARTICIPATED MOST RECENTLY IN (YEAR) ______Where do you prefer placement this year? (CIRCLE GROUP) A B C D E

IF A FIRST TIME PARTICIPANT LIST ONE PIECE THAT REPRESENTS STUDENT LEVEL OF PERFORMANCE AND WE’LL PLACE THEM IN THE APPROPRIATE GROUP: Title:______Composer: ______T-shirt size ______TOTAL YRS.PARTCIPATED:_____

*STUDENT NAME: ____________SCHOOL GRADE:______YEARS OF PIANO STUDY______

PARTICIPATED MOST RECENTLY IN (YEAR) ______Where do you prefer placement this year? (CIRCLE GROUP) A B C D E

IF A FIRST TIME PARTICIPANT LIST ONE PIECE THAT REPRESENTS STUDENT LEVEL OF PERFORMANCE AND WE’LL PLACE THEM IN THE APPROPRIATE GROUP: Title:______Composer: ______T-shirt size ______TOTAL YRS.PARTCIPATED:_____

*STUDENT NAME: ____________SCHOOL GRADE:______YEARS OF PIANO STUDY______

PARTICIPATED MOST RECENTLY IN (YEAR) ______Where do you prefer placement this year? (CIRCLE GROUP) A B C D E

IF A FIRST TIME PARTICIPANT LIST ONE PIECE THAT REPRESENTS STUDENT LEVEL OF PERFORMANCE AND WE’LL PLACE THEM IN THE APPROPRIATE GROUP: Title:______Composer: ______T-shirt size ______TOTAL YRS.PARTCIPATED:_____

This Registration Form must be postmarked by AUGUST 1, 2016. (Mail sooner if possible.) Music will be mailed to teachers as soon as possible.Mail registration to: Lori Hughes 2320 W. Adkins Dr. Ashland, KY 41102 Registration form may be copied if additional space is needed.