60th PMTA Piano Ensemble Online Registration
Registration Deadline: October 31st

Registration Fee: $15.00 per student

Teacher Information
Teacher's Name:
Phone:
Address:
Zip:
Total # of Students:
Email Address:
What job are you willing to do at this event?

Each of these students has a signed copy of the 2012 Piano Ensemble Student Information
Form in their black performer’s folder.

Teacher Initials:


Please fill out all applicable information below. List the part that each student is playing. If you are registering a student without a partner, please do not begin the piece. The chairperson will call you to assign a part when a partner is selected. Please make note of all students who are members of the same family so they will be placed in the same concert.  
Student/Partner 1 Information
Student Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:
Partner Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:

If you are finished entering students, click here to be taken to the "Submit" button. If you have more students to enter, please continue to next box.


Student/Partner 2 Information
Student Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:
Partner Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:

If you are finished entering students, click here to be taken to the "Submit" button. If you have more students to enter, please continue to next box.


Student/Partner 3 Information
Student Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:
Partner Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:

If you are finished entering students, click here to be taken to the "Submit" button. If you have more students to enter, please continue to next box.


Student/Partner 4 Information
Student Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:
Partner Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:

If you are finished entering students, click here to be taken to the "Submit" button. If you have more students to enter, please continue to next box.


Student/Partner 5 Information
Student Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:
Partner Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:

If you are finished entering students, click here to be taken to the "Submit" button. If you have more students to enter, please continue to next box.


Student/Partner 6 Information
Student Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:
Partner Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:

If you are finished entering students, click here to be taken to the "Submit" button. If you have more students to enter, please continue to next box.


Student/Partner 7 Information
Student Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:
Partner Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:

If you are finished entering students, click here to be taken to the "Submit" button. If you have more students to enter, please continue to next box.


Student/Partner 8 Information
Student Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:
Partner Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:

If you are finished entering students, click here to be taken to the "Submit" button. If you have more students to enter, please continue to next box.


Student/Partner 9 Information
Student Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:
Partner Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:

If you are finished entering students, click here to be taken to the "Submit" button. If you have more students to enter, please continue to next box.


Student/Partner 10 Information
Student Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:
Partner Name:
Age as of 9/11:
Grade as of 9/11:
Group/Title Selection:
Part Preferred:
Place in same concert as [name of family member]:
Years participating, including 2012:

Note: After clicking submit, you will be directed to a page with a link to payment instructions.