Teacher's Name *
EPTA Membership Number *
Teacher's Email address *
Teacher's Contact Number *
--------------------------------------------------------------------------
Competitor's Name *
Competitor's Contact Number *
Competitor's Email Address *
Name of School *
School Address (Line 1) *
School Address (Line 2)
School Year (1-6) *
Date of Birth *
--------------------------------------------------------------------------
Name of Competition *
Full Title of Piece *
Composer *
Duration *
--------------------------------------------------------------------------
I confirm that I have read the Rules and Regulations *
 
IMPORTANT: Please do not alter the "Quantity" option in the next screen
The cost of only entry to Full EPTA members is €12.50 per competitor