David Benoit, Music Director and Conductor Joe Marino, Assistant Conductor Please fill out and submit this form for an audition with the Asia America Symphony. Alternatively, you may print and fill out this form and mail to: 608 Silver Spur Rd. #320, Rolling Hills Estates, CA, 90274 or fax to 310-377-8949. Student Name* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Student's Cell PhoneStudent's Email* Returning Member*YesNoBirthday* Age*Audition Instrument(s)*Number of Years Played*Parent InformationFather's Name First Last Father's Email Father's EmployerFather's OccupationFather's Work PhoneFather's Cell PhoneMother's Name First Last Mother's Email Mother's EmployerMother's OccupationMother's Work PhoneMother's Cell PhoneSchool InformationSchool*Grade (This Fall School Year)*5th6th7th8th9th10th11th12thDo you participate in school band?*YesNoOrchestra?*YesNoOther orchestra or bandSchool Music Director's Name First Last Music Director's PhoneMusic Director's AddressMusic Director's Email Private Music Instructor's Name First Last Music Instructor's PhoneMusic Instructor's Email Other Music/Orchestra ExperienceAwards/CompetitionPayment of $350.00 annual membership fee (due on acceptance) After submission of this application, please await an email from the Pacific Vision Youth Symphony office to schedule your audition
