The form below may be used by prospective campers. You may either fill out this online form, which will be sent via email to Signature Music Camp, or you may print out a PDF of our application form and send it in by mail.

Also note that you must separately send payment for your tuition deposit by check to the address listed on our site below.

PLEASE NOTE:

THIS IS A TWO-PAGE FORM. If you fill out the form and click "Next Page," yet you end up back on the same page, check the information you have entered.

Any boxes that are HIGHLIGHTED IN RED after an incorrect submission are REQUIRED (these boxes are also indicated as such with an asterisk [*]). YOUR APPLICATION WILL NOT BE SUBMITTED UNLESS YOU'VE FILLED ALL REQUIRED FIELDS.

Camp accepts students entering grades 8-12, runs July 15-July 28, and costs $2,100. Early registration before April 1, 2011 affords a $250 discount, for a total of $1,850.

Name

First Name: *
Middle Name:
Last Name: *
Nickname:
Address
Number and Street: *
Apartment No.:
City: *
State: *		- Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming
Zip: *
Personal Information
Birthday
Month: *		- Select -JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
Day: *
Year: *
Gender: *
Male
Female
Grade in school last fall: *
Home Phone: *
Cell Phone:
Part 3
Parent/Guardian Information
Applicant normally lives with: *
Parent email address: *
Father or Guardian
Name: *
Address: *
Home Phone: *
Work Phone:
Cell Phone:
Mother or Guardian
Name:
Address:
Home Phone:
Work Phone:
Cell Phone: