Student Application

First Name:
Last Name:
Home Phone:
Work Phone:
Cell Phone (parents):
E-mail (parents):
Age (in July):	Sex: Female Male
Address:
City:
State:	Zip: Country:

Grade in School (Sept. '10):
Name of School:
Address of School:
City:
State:	Zip: Country:

Major Instrument/Voice:		Years Studied:
Minor Instrument/Voice:		Years Studied:

School Music Teacher's Name:
School Music Teacher's Address:
Private Music Teacher's Name:

Private Music Teacher's Address::
(name)	(address)	(city)	(state)	(zip)

A friend who may be interested in attending:
(name)	(address)	(city)	(state)	(zip)

Classes offered include:  Theory, Harmony, Beginning Theory, Composition/Arranging, Improvisation, and Conducting. Selection to be made on Registration Day. Our faculty will assist you with your selection..

How did you learn about Eastern U.S. Music Camp? (please be specific)

How did you find the Eastern U.S. Music Camp Website?

I plan to attend (check one): 2 weeks -------------> 3 weeks -------------> 4 weeks ------------->

beginning Sunday (check one - do not omit): June 27 - July 11  July 4 - 18   July 11 - 24 June 27 - July 18  July 4 - 24 June 27 - July 24

Maximum enrollment: 250 students per two-week session.

The cost of my program is (press arrow to right for 2-3-4 week fees): ** Resident: Includes Instruction, campus health services, Room & Board ** $2,149 for two weeks $3,223 for three weeks $4,298 for four weeks ** Day Student: Includes Instruction, campus health services, & Complete Program with Lunch ** $859 for two weeks $1,288 for three weeks $1,718 for four weeks

Applications are accepted on a first serve basis. By submitting this form, I understand that upon receipt of your Eastern U.S. Music Camp Student Application and Registration Fee, no refunds or deductions for the cost of the program will be made for any reason including late arrival, early departure, sickness or expulsion for disciplinary reasons as explained by the rules distributed upon arrival by the Eastern U.S. Music Camp, Colgate University, federal, state and local law.

To make a reservation, please mail the non-refundable deposit of $395 (part of total cost) along with the printed application.   The deposit is part of the total cost.  The balance must be paid by June 15, 2010. All checks should be made payable to Eastern U.S. Music Camp, Inc. Please mail the deposit to the address below. (Credit may be earned when enrolled in the full four-week program.)

Please mail all applications, deposits, and balances to:
Eastern U.S. Music Camp, Inc.
7 Brook Hollow Road
Ballston Lake, NY 12019

For further questions, you are always welcome to call:
Toll Free: 1-866-777-7841
Tel. 1-518-877-5121
Fax. 1-518-877-4943
E-mail: summer@EasternUSMusicCamp.com

Summer Address (June 27-July 24, 2010)
Colgate University
Dana Arts Center
Hamilton, NY 13346-1398
Music Camp Office
Summer Telephone: 315-228-7041
Summer Fax: 315-228-7557