Suzuki Music
170 Southbank Blvd
Southbank VIC 3006
Ph: 9681 6933 Fax: 9681 6977
Application for Suzuki Primary Accreditation Course
2005
Name ________________________________________________________________________________________
Address ______________________________________________________________________________________
Suburb _______________________________________________________ Postcode ______________________
(H) ___________________________________________ (M)______________________________________
Email _________________________________________________________________________________________
Instrument: Please
Piano
Violin Viola Cello Flute Guitar Voice
Qualifications: (eg. Relevant degrees or diplomas, highest level attained on your instrument ;
level attained in music theory). Attach photocopies of relevant music certificates/degrees.
Degree
Institution
Years
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Examination Level / Graduation Level
Year
Result
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Teaching Experience (eg. number of years you have been teaching, how many
students, to what level you have taught, school teaching experience etc.)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Audition Repertoire (No accompaniment needed)
Cello Popper Gavotte AND Saint-Saens Allegro Appassionato
Flute, Guitar Any two contrasting works
Piano - One movement from a classical sonata plus one other work
Violin Bach A minor Concerto (complete)
1. Title
Composer
2. Title
Composer
Application Fee (non refundable): $35
Please
Cheque
Money order
Card
Mastercard
Bankcard
Visa
Name of Cardholder__________________________________ Signature ______________________________________
Card Number
_ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _
Expiry Date
_ _ / _ _
Signature of Applicant
Date
