Point Loma Keyboard Institute Application

Application deadline is June 7, 2010

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Please provide an email address to receive a copy of your submitted application:  Enter a valid email address. Example: name@company.com Student's Name: Parent's Name(s): Address (line 1): Address (line 2): Phone:  Enter a valid phone number. Example: 123-456-7890 Student's Age: What is your expected year of graduation from high school? The Point Loma Keyboard Institute is for pianists age 12-18. Approximate MTAC Certificate of Merit Level: Teacher's Name: Teacher's Phone:  Enter a valid phone number. Example: 123-456-7890

• $30.00 non-refundable deposit postmarked by June 7, 2010, balance due at registration
• $250.00 Institute Tuition
• Please make checks payable to PLNU
• Please mail checks to:

Point Loma Keyboard Institute
Department of Music
Point Loma Nazarene University
3900 Lomaland Drive 
San Diego, CA 92106-2899