Please fill out the registration form in full (including exact repertoire).

* Required Field

First Name *

Last Name *

Gender
—Please choose an option—MaleFemale

National ID *

Date of birth *

Country

Instrument *
ViolinViolaCello

Years of playing *

Address *

Student mobile *

Parent mobile *

Student Email *

Parent Email *

Music School *

Name of principal

Teacher's Name *

Teacher's mobile

Teacher's Email

I confirm my participation in the Keshet Eilon Seminar*
It is the responsibility of the student to ensure that the teacher sends a confirmation email to the seminar directly to: [email protected]*
I agree Keshet Eilon to use the filmed and recorded materials that I will pass on for the seminar as well as the photos or recordings that are shared by all the seminar participants.*

Please specify special requests for the seminar. Every effort will be made to accommodate your needs:

Teacher preferences (please list 3 names in order of preference)

1.
2.
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Works on which I will work at the seminar *

Please submit a list of the works you plan to work on during the seminar, the list should be written in English and in printed letters. Be specific – include composer, title, giving all details and correct spellings as shown on the sample bellow.

Composer (name and dates)	Composition name in full (including No. Op, etc)	Movements
J. S. Bach (1685-1750)	Partita No. 2 in d minor, BWV 1009	Largo Allegro

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