I believe my student:

_______is capable of fulfilling all the requirements of the 41st Annual Youth Concerto Competition,

_______has consulted the rules, and

_______has selected a piece from the official Repertoire List.

STUDENT: ______________________________________________

TEACHER: ______________________________________________

TEACHER ADDRESS:_____________________________________

CITY/STATE/ZIP: ________________________________________

PHONE NUMBER: _______________________________________

CELL PHONE: _______________________________________

TEACHER E-MAIL (checked daily):

_______________________________________

TEACHER SIGNATURE: __________________________________

DATE:__________________________________________________