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2023 AKTA/AMTA Virtual Adjudications Form Adjudicator: To be Announced
Please return this completed form no later than October 20, 2023
. Any late forms will not be processed.
Submission of videos deadline is November 11, 2023 - Attach videos to an email to
pianoakta@gmail.com
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Email
*
Your email
Instructor's First & Last Name
*
Your answer
Phone Number:
*
Your answer
Do you receive text messages at this number?
*
Yes
No
How many students are you registering and at what level? If you have no students at a given level, please enter none. Scroll right to enter more than 7 students.
*
None
1 Student
2 Students
3 Students
4 Students
5 Students
6 Students
7 Students
8 Students
9 Students
10 Students
11 Students
12 Students
13 Students
14 Students
15 or more Students
Early Elementary through Elementary $25
Late Elementary through Intermediate $35
Late Intermediate through Advanced $45
None
1 Student
2 Students
3 Students
4 Students
5 Students
6 Students
7 Students
8 Students
9 Students
10 Students
11 Students
12 Students
13 Students
14 Students
15 or more Students
Early Elementary through Elementary $25
Late Elementary through Intermediate $35
Late Intermediate through Advanced $45
I am interested in having a 15 minute teacher conference with the adjudicator. The date and time will be agreed upon by the adjudicator and the teacher. The meeting can be via phone or video chat. The fee is $15
Yes
No
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I understand that once I submit this form, I will receive further instructions on submission of the videos and other required documents.
*
.
Yes
No
I understand my registration form is not complete until payment is paid in full. You will receive a PayPal invoice by the event coordinator after this form is submitted.
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Yes
No
Any special requests or concerns?
Your answer
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