Phone Number809-616-2335 Email[email protected] AddressWinston Churchill Ave. No. 1099, Acrópolis Plaza, 3er. Level, Piantini, Santo Domingo, National DistrictDominican Repúblic Contact Us! Fist Name Last Name Email Phone Questions or Comments Contact Us! Names Surnames Email We use e-mail to communicate; please verify that your e-mail address is entered correctly City of Residence (current) Country of Residence (current) Contact Telephone Number Country Code-Country Area-Number Country of Birth Nationality If you have more than one nationality, you must indicate on this box the one that accredits you as a national of a Caribbean island, except in the cases of those with legal residence for over 5 years Type of Identity Document Attach scanned copies in real size, legible and in color. All documents should be issued by a competent authority. Certificate of Birth Mandatory Document Passport National Identity Document/ID Card Certificate of Nationalization If foreigner nationalized in a Caribbean island Certificate of Legal Residence/Visa If foreiginer with more than 5 years of legal residence in a Caribbean island Gender MaleFemale Date of Birth Name of Musical Center or Musical School currently attending (if applicable) How did you hear about YMoCA? WebSocial MediaPressRadioSchool, Music School or AcademyABRSMEmbassy/ConsulateOther Age Category Junior (born in 2005 to 2009)Senior (born in 2000 to 2004)Young Professional (born in 1995 to 1999) Musical Certification/Level Musical Experience (if applicable) Performance in concerts or other classical music competitions Musical Instrument (1) YouTube Video Link (1) Refer to pages 2 and 3 of the Bases and Regulations on the time limits and important information related to the YouTube video to be submitted Works presented on YouTube video (1) Indicate the name of the composer, title of the piece, tonality, opus number, duration etc. Several works may be performed respecting the time limits indicated for each category. Do you want to participate playing another musical instrument? YesNo Musical Instrument (2) YouTube Video Link (2) Refer to pages 2 and 3 of the Bases and Regulations on the time limits and important information related to the YouTube video to be submitted Works presented on YouTube video (2) Indicate the name of the composer, title of the piece, tonality, opus number, duration etc. Several works may be performed respecting the time limits indicated for each category. IN THE CASE OF MINORS Please complete this section if you are under 18 years of age on the competition registration date Names and Surnames of Father or Mother or Tutor Contact telephone number of Father or Mother or Tutor Country Code-Country Area-Number Email of Father or Mother or Tutor Type of Identity Document Attach scanned copies in real size, legible and in color. All documents should be issued by a competent authority. Passport National Identity Document/ID Card CONSENTS AND SUBMISSION Please verify that you have completed your form accurately and attached all the required documentation. If any document is missing or if you submit your registration out of date, the application will not be accepted and you will not be able to participate in the competition. I agree to be part of the BritchamDR Young Musician of the Caribbean Award and to comply with the Rules and Regulations of the competition. As a condition of registration, I hereby consent to the recording of my contribution and performance subject to the Terms and Conditions of the competition. In the case of minors, as father or mother / guardian I hereby grant my express consent and authorization for the participation of my young musician in the BritchamDR Young Musician of the Caribbean Award, accepting compliance with the Bases and Regulations, as well as with the Terms and Conditions of the competition.
