Please affix your photo Application Form Please tick (√) Category A Category B Category C Pop Piano SoloSolo Junior Pop Piano SoloSolo Open Pop Piano Ensemble Application Fees RM 10 per pax RM 20 per pax Closing Date: Yamaha Student Non Yamaha Student 31 July 2012 New I.C. No Name as per IC (Mr./Mrs./Miss) Nationality Date of Birth (dd/mm/yyyy) Age Gender (M / F) Tel / HP No Residential Address Email Address Occupation Participation in past musical usical events (if any) Music Qualification & Music School (if any) Repertoire For Category C only Title : Duration : Name Of Composer /Arranger: Group Name: No of group members: Applicant Agreement I declare that the above information given is complete & true. I shall abide by all the Rules & Regulations of the competition as given. Competition matters which are not covered by the Rules & Regulations shall be determined by Yamaha Music (M) Sdn. Bhd. Signature of Applicant: Signature of Parent or Guardian (participant who is below 18 years old): Date: