Name: ________________________________________________________________ (Please print clearly or reproduce on a computer)

*Nationality: ________________________________________________________________

*Date of Birth: ________________________________________________________________

Address: ________________________________________________________________

(street and number)

City: ________________________________________________________________

Zip Code/Postal Code: ________________________________________________________________

State/Country: ________________________________________________________________

E-mail address: ________________________________________________________________

Telephone Number: ________________________________________________________________

(Please include international calling code - we will not process your application without a telephone number where you can be reached after June 1, 2006)

Please use this checklist to insure that all required elements are included with this application. All items must be included in one package:

_____ Curriculum Vitae

_____ Performance Videotape (DVD or VHS Format)

_____ Recent Photo

_____ Biographical Sketch

_____ List of Repertoire Conducted

_____ Competition Repertoire Selections (download repertoire form here)

_____ $100 Non-refundable processing fee ((made payable to Jordania International Conducting Competition) — Please note Ñ all checks must be written in U.S. Dollars - NO BANK TRANSFERS WILL BE ACCEPTED

Vakhtang Jordania International Conducting Competition
7457 Preston Circle
Chattanooga Tennessee 37421
USA

Questions? Contact Jeffrey James Arts Consulting at 516-586-3433 or by email at jamesarts@worldnet.att.net or Joan Murray at 423-894-5748 or by email at clownjoni@aol.com.

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