The Encounter Application Education Programs Office • 208-578-5464 • N/A Prior to completing this application, please refer to the APPLICATION AND AUDITION RECORDING INSTRUCTIONS. You may also call or email the SVSS education office with questions at N/A or 208-578-5464. PROGRAM APPLYING FOR (select one. refer to application instructions for detailed program descriptions)* Strings Voice Piano PRIMARY INSTRUMENT OR VOCAL RANGE (select one)* violin viola cello string bass other soprano 1 soprano 2 alto 1 alto 2 tenor 1 tenor 2 baritone bass piano Member of pre-formed ensemble (string students only)? I wish to be considered for placement in a pre-formed ensemble. (All members of the ensemble must be accepted to The Encounter. Placement in a pre-formed ensemble is not guaranteed.) List Other Ensemble Members STUDENT INFORMATION Name* First Last Other Name Gender* Male Female Date of Birth* MM DD YYYY Age* Grade Level as of Fall 2017* CONTACT INFORMATION Permanent Mailing Address (street or P.O. Box)* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home phone* Cell phone or alternate phone (student phone if available) Student Email* Parent or Guardian Email School attended in 2016-17 List Music Instructor(s) New or returning student (select one)* new student returning student Referred by (select one) school music teacher private instructor friend Friend’s first and last name Polo Shirt Size (all sizes are adult sizes)* extra small small medium large extra large XXL PHOTO RELEASE* I understand that images or videos of my student may be taken during the workshops and recitals. These images are the property of the SVSS and may be used in promotional materials. The SVSS may use images of my student. Yes No Audition Recordings Please post your audition on YouTube and provide the link below. Audition 1 Audition 2 Audition 3 Audition 4 BILLING INFORMATION (please complete information for responsible billing party) Responsible party name* First Last Responsible party address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Responsible party home phone number* Responsible party work or cell phone number Responsible party email* HOUSING INFORMATION* I plan to stay in the Community School/SMW Residence Hall. (See housing page for more information, cost and link to application form.) I plan to make my own housing arrangements. (You will be contacted to provide information about where you are staying during Workshops prior to check-in.) SCHOLARSHIP and DISCOUNTS See Fees and Scholarship section on Website for more information about Scholarships and Discounts and to download a scholarship application) I am interested in applying for a Scholarship I am interested in being considered for a teaching assistant position (up to $100 discount, positions are limited) I may qualify for the following discounts. (Must be verified and approved by Education Office.) Bring a Friend (List up to 3 friends and receive $25 off your fees per friend. Friends cannot be relatives and must also be accepted to The Encounter.) Honor Groups (Up to $50 discount for groups like All-State, All-Northwest, other regional or national honor groups that require an audition.) Competition placement (Up to $50 discount for placing first or second in State Solo, Accredited Concerto Competition or other accredited competition.) List Friends* List Honor Groups* List Competitions and Placement* FEES Encounter Application Fee (non-refundable): $30 Full Registration and Materials Fee: $200 Community School Residence Hall Boarding Deposit: $50 Community School Residence Hall Boarding Total Fee: $650 The Encounter Application Fee ($30) is due at the time of application and is non-refundable. If accepted, the fee will be subtracted from the total Registration Fee and you will be billed for the balance in early May. The remainder of the Fee is Due by June 1, 2017. If you choose to board at the Community School Residence Hall, you must secure your spot with a $50 deposit. You will be billed for the remaining boarding fees upon acceptance. (The boarding deposit is refundable if you are not accepted into to the program). Boarding Fee may be paid in installments, please contact the Education Office to set up a payment plan. Boarding Fees are due in full by July 10, 2017 (NO FEES WILL BE REFUNDED AFTER JULY 18, 2017) You may pay the deposits on-line with a credit or debit card or mail a check to SVSS Sumer Music Institute, P.O. Box 3956, Hailey ID 83333. If you are applying for financial assistance through our scholarship program or think you qualify for one or more of Encounter Student Discounts listed on the Application, please pay only the $30 Application Fee and $50 Boarding Deposit (if applicable) at this time. You will be notified in mid-May if your request and/or discounts were approved. Pay Fees Online Pay Fees Online Online Fees $30 Encounter Application Fee, required (non-refundable) $50 Encounter Boarding Deposit (if planning to stay in the Community School Residence Hall) Donation, please specify amount below Other, please specify amount below $30 Encounter Price: $30.00 $50 Boarding Price: $50.00 Donation Other Total $0.00 Credit Card American Express Discover MasterCard Visa Card Number Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Expiration Date Security Code Cardholder Name Phone This field is for validation purposes and should be left unchanged.