Recital Application Form

* Required Field

Recital Information

Recital Date, Time and Location

Performer Information

* Name
* Age
* Musical grade
* Parent/Guardian Name
* Home Phone
* Cell Phone
* E-mail address
* Instrument

Lesson Information

* Instructor
Lesson Day
Lesson Time

Performance Information

The title of the selection is what will appear in the program. For movements of a larger work, please include the full title of the work and the tempo marking of the movement for identification.

* Title of 1st Selection
* Composer
* Time (MM:SS)
Title of 2nd Selection
Time (MM:SS)

Accompanist Information

Is an accompanist required? Yes No
Accompanist name

The University of Regina collects information under the authority of The University of Regina Act and in accordance with the Local Authority Freedom of Information and Protection of Privacy Act and the Personal Information Protection and Electronic Documents Act for purposes of the administration of the University and its programs and services. By submitting this form, you are consenting to the University of Regina Residences using your personal information to contact you about and/or administer your request.