Cremona Academy Online Application for PIANO

Use this form to apply to the 18-Day Program (July 11-July 28, 2023)
PLEASE NOTE: All fields marked with * (asterisks) are mandatory fields that must be filled out in order to process the form.

Student Information

First Name (as appears in the Passport/Travel Document)*

Middle Name (as appears in the Passport/Travel Document)

Last Name (as appears in the Passport/Travel Document)*

Date of Birth*

Gender*

Citizenship*

Country of Residence*

Do you need a visa to travel to Italy?*

Yes
No

Permanent Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Country*

Mailing Address (if different from permanent address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Country

Home Phone

Mobile Phone*

Email*

Additional Email

WhatsApp ID*

How did you learn about the Academy?*

Musical Information

Years of Study*

Please enter a number from 1 to 99.

Current School (if applicable)

Current Degree (if applicable)

Name of Current Private Teacher

Do you play second instrument/voice? (Enter instrument or voice type if applicable)

If “Yes”, please indicate the name of private teacher.

Would you like to take lessons/classes on the second instrument?

Yes
No

PRIVATE LESSONS

Please indicate one or more private teacher(s) you would like to study with (8 private lessons in total).

Teacher Preference #1*

Number of Lessons (Teacher #1)*
Please enter a number from 1 to 8.
Please enter a number from 1 to 8.

Teacher Preference #2

Number of Lessons (Teacher #2)
Please enter a number from 1 to 8.
Please enter a number from 1 to 8.

Teacher Preference #3

Number of Lessons (Teacher #3)
Please enter a number from 1 to 8.
Please enter a number from 1 to 8.

Please list repertoire you plan to study at the Academy.

Please list repertoire you have performed or studied in the last two years.

Are you interested in taking Optional Classes?*

Yes

No

Please indicate the classes you would like to take:
Composition Class
Conducting Class
Competition Preparation Class
Audition Preparation Class
Improvisation Class
Ear Training, Theory, and Musicianship
Collaborative Piano Class
Introduction to Historical Keyboard Class (hand-on class for pianists)

Have you played chamber music before?

Yes

No

If you have played chamber music before, please list works you have studied and performed in the last two years.

AUDITION RECORDINGS

Link to Recording #1*

Link to Recording #2*

Link to Recording #3 (optional)

Parent/Guardian #1 Information

PLEASE NOTE: All children under the age of 12 must be accompanied by parent/guardian.

First Name

Last Name

Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Country of Parent/Guardian #1

Home Phone

Mobile Phone

Email

Alternate Email (Optional)

Please indicate whether you will be accompanying your child. If “Yes”, complete and submit separate “Non-Participant” Form.

Yes

No

Please indicate whether someone else will accompany your child.

Yes

No

Parent/Guardian #2 Information

PLEASE NOTE: All children under the age of 12 must be accompanied by parent/guardian.

First Name

Last Name

Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Country of Parent/Guardian #2

Home Phone

Mobile Phone

Email

Alternate Email (Optional)

Please indicate whether you will be accompanying your child. If “Yes”, complete and submit separate “Non-Participant” Form.

Yes

No

Please indicate whether someone else will accompany your child.

Yes

No

Lodging Information

Please indicate where you will be staying during the Academy. PLEASE NOTE: All unaccompanied minors (students under the age of 18) are required to use Room and Board Plan provided by the Academy.

Student*

Academy Room and Board Plan

Own Arrangements

Parent/Guardian

Academy Accommodation

Own Arrangements

Sightseeing Tours

PLEASE NOTE: Tours are mandatory for all unaccompanied minors (students under the age of 18).

Will you be taking part in the sightseeing tour of the Lombardy region?*

Yes

No

If yes, how many people will take part in the sightseeing tour of the Lombardy region?
Please enter a number from 1 to 6.

Travel Information

Would you like the Academy to arrange your transportation from/to the airport (additional fee of 55EUR/US$65 per person each way applies)?*

Yes

No

If yes, how many people will be traveling?
Please enter a number from 1 to 9.

Enter Number of Round-Trip Tickets Malpensa Airport – Cremona
Please enter a number from 1 to 9.

Enter number of one-way tickets from Malpensa Airport to Cremona
Please enter a number from 1 to 9.

Enter number of one-way tickets from Cremona to Malpensa Airport
Please enter a number from 1 to 9.

Please provide any additional information regarding airport transportation needs.

Emergency Contact Information

Emergency Contact Name*
First Last

Emergency Contact Phone*

Emergency Contact Email*

Terms and Conditions / Agreement

I declare that the information stated above in this application form is complete and truthful. I agree to observe and abide to all of the Academy's rules of participation, listed in the agreement of participation and I understand that “Cremona International Music Academy” and “International Music Academies” may not be held liable for any personal injury or illness or damage to property that may occur during the Academy. I understand that each participant is required to secure health insurance in case of illness or accident, as well as Property insurance for his or her instrument and bow. I agree to release “Cremona International Music Academy”, “International Music Academies”, and all attendant persons from liability.

I agree to the terms and conditions above.*
Yes

Student Signature*
Students over 18: You must enter your full name here. Your application will not be complete without this signature.

REQUIRED: Signature (Full Name) of Parent/Guardian for all minors (students under the age of 18).
For any minor student, this application will not be complete without this signature.

REQUIRED: Today's Date*
MM slash DD slash YYYY

Submit and Make a Payment (see Admission Page for payment details)

PLEASE NOTE: Applications will not be accepted without payment of the Application Fee and a deposit of the Program Fee at the time of application.