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ALL PARTICIPANTS MUST FILL OUT A HEALTH FORM.
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You can download the PDF version by clicking here. Once downloaded, fill out the HEALTH FORM section, and have the student bring it with them to the seminar or FAX it ATTN: Kevin Sanders to (479) 788-7559. If under 18, this form needs to be signed by the student's parents/guardian.
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*
= Required Field
Name:
*Last
*First
M.I.
*Age:
*E-mail:
*Re-enter your email address:
*Gender:
M
F
Address:
*Street
*City
*State
*Zip
*Day/Cell phone:
Evening phone:
*School name:
*School city/State:
Band Director:
List any honors you have received, all-region/all-state seating, chair in your high school/college music program, etc…
REFER A FRIEND: If you were referred to the National Brass Academy by someone who is already registered, enter their name below. This person will receive a $15 credit towards tuition. Brass Academy Referral:
MAJOR INSTRUMENT (select one):
160
265
70
25
35
COMMUTER STUDENT $160
• For students who can travel to campus for the day's activites.
RESIDENT STUDENT $265
• Live on campus in the Sebastian Commons Apartments.
MEAL PLAN $70
• This includes lunch and dinner for Monday - Friday.
• The Sebastian Commons Apartments are equipped with a full kitchen if you would like
to make your own meals.
CONCERTO COMPETITION
High School Division registration fee $25
College Division Registration Fee $35
• Compete in the concerto competition for a cash prize.
LATE REGISTRATION FEE
$25
• For applications submitted after June 8
Total Amount Due
$
All payment is made out to the
University of Arkansas-Fort Smith
c/o National Brass Academy
Office
Payment Information
Send check (payable to UA-Fort Smith c/o National Brass Academy) :
University of Arkansas-Fort Smith
ATTN: Kevin Sanders, National Brass Academy
5210 Grand Avenue, P.O. Box 3649
Fort Smith, AR 72913
Fax: (479) 788-7559
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