Russell C. Wonderlic Memorial Competition – Piano 2018

Official Application Form

Name: _______________________________________________ Date of Birth: _________________________

Current Address: _____________________________________________________________________________

Telephone: __________________ Cell: ____________________ Email: ________________________________

Permanent Address, if different from above: ______________________________________________________

___________________________________________________________________________________________

If a non-resident attending a school in Maryland or D.C., or a Maryland or D.C. resident attending an out of

state school, list the school at which you are currently enrolled:

___________________________________________________________________________________________

Formal study, starting with the most recent dates:

(as applicable)

Year Institution/Teacher Diploma/Degrees

_________________ ________________________________________ __________________________

_________________ ________________________________________ __________________________

_________________ ________________________________________ __________________________

Teacher, Coach or Sponsor’s Name: ________________________________ Phone: _____________________

Sponsor’s signature: _____________________________________________ Date: ______________________

I, the undersigned applicant certify that the foregoing information is true and correct. If accepted, I agree to

appear for the competition on Saturday, April 7, 2018 in accordance with the schedule as arranged.

If I am selected as a finalist, I hereby agree to perform a recital, partial or full, as determined by the

competition, on Sunday, April 22, 2018. Both appearances will be held at the Second Presbyterian Church

in Baltimore.

_______________________________________________________________ __________________________

Signature of applicant Date

Please email the following materials to wonderlic@communityconcertsatsecond.org:

1. This application form

2. Program - including titles, composers’ names & birth/death dates, and the timings of each selection

3. $40 non-refundable application fee (payable online at communityconcertsatsecond.org/wonderlic)

If you are unable to submit your payment online, please send your $40 application check (made payable to

Community Concerts at Second) by mail to:

Wonderlic Competition, c/o Christina Manceor

Community Concerts at Second

4200 St. Paul Street

Baltimore, MD 21218

DEADLINE: All application materials must be received no later than March 16, 2018