<p> Shepherd University Department of Music Preparatory Division Request to perform on Recital, April 29, 2017</p><p>Turn in to Room 118 Sherry Sykes, Coordinator for Preparatory Division By April 15, 2017 (please type or print clearly)</p><p>Recital Date: Saturday, April 29, 2017</p><p>Recital Times: 10:00am 11:30am Please circle first choice</p><p>Name of Student: ______</p><p>Name of Instrument: ______</p><p>Name of Instructor: ______</p><p>Work to be Performed: ______</p><p>______Estimated length of piece to be performed: ______Is the student: beginner, intermediate, advanced? ______</p><p>Please be specific, List movement of piece, composer, birth and death dates of composer. ****Length of Performance cannot exceed 5 minutes without permission from instructor and Prep. Coordinator.</p><p>______Student signature Date</p><p>______Parent signature Date</p><p>______Instructor signature Date</p>