Music at Port Milford

2019 Application Form
for string and wind students and pianists ages 12-18

Send this application form to:
Music at Port Milford
288 Washington Ave.
Pleasantville, NY 10570
and include:

  • CD or DVD of an audio or video recording with two contrasting pieces or movements (alternatively, email youtube links to
  • $45 non-refundable processing fee made out to "Music at Port Milford"
  • letter of recommendation from a private or school music teacher (new students only)
  • __ Full Session (July 21 - August 18; strings only)
    __ Session I (July 21 - August 4; strings, winds, pianists)
    __ Session II (August 5 - August 18; strings only)

    Name: Date of Birth: Instrument:

    Years of Study:
    City: State/Province: Zip/Postal:
    Parent Email address:
    Student Email address:
    Parent(s) name(s): Telephone(s):
    Teacher's name: Teacher's Phone:
    Teacher's email address:
    Teacher's address:
    Current solo, chamber or orchestra music repertoire you are working on (specify pieces on reverse or on separate paper, as needed):
    Past chamber repertoire, if applicable (specify pieces on reverse or on separate paper, as needed):
    How did you hear about us?
    If you have a Promo Code, enter it here:
    Parent or guardian's signature:
    Details on What to Bring, Maps and Tourist facilities in Prince Edward County will be sent upon acceptance.