Young Texas Artists Music Competition Application Form
Secure Payment Form

 
Application Information:
Date: 12/18/18
Please select $55.00 for Application Fee only or $155.00 for Application Fee and Accompanist Fee:
Description:
Date of Birth (MM/DD/YYYY):  
Age on March 11, 2017:  
Country of Citizenship:  
Gender: Male
Female
 
For which division are you applying?:
Instrument or Voice Type:  
Will you require accommodations in an area home?: No
Yes
 
Degrees earned or expected (check all that apply): D.M.A
M.M.
B.M.
B.M.E.
Other
 
School from which you expect/have earned your most recent degree:  
           
Credit Card Information:
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Name as on Card:
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Card Billing Zipcode:
Card Number:
Card Expiration Date: MMYY
Card ID (CVV2/CID) Number:
 
[What is the Card ID?]
   
Present Address:
First Name:
Last Name:
Address:
Address Line 2:
City:
State:
Zip:
Country:
Phone Number:
Email Address:
     
   
Permanent Address:
First Name:
Last Name:
Address:
Address Line 2:
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Zip:
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