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CLASSNUMBER
CLASSDESCRIPTION
NAME OF COMPETITOR – SOLOONLY
PLEASEPRINT CLEARLY
DATE OFBIRTH
AGE AS AT31/12/15
ENTRY FEE
SUB TOTAL $THREE SEPARATE PROGRAMS WILL BE PRINTED Office
Use
OnlyVocal/Instrumental No ordered @ $4.00 each $Dance No ordered
@ $4.00 each $Speech & Drama No ordered @ $4.00 each $
SUB TOTAL PAGE 1 $
SUB TOTAL PAGE 2 $
SUB TOTAL PAGE 3 $
TOTAL $
Entry form must be accompanied by FULL ENTRY FEE paid by
CHEQUE/MONEY ORDER made payable toCity of Dubbo Eisteddfod Inc. OR
DIRECT DEPOSIT to BSB: 932 000 ACC NO: 26026.
Attach EFT receipt with entry form.
Office Use OnlyEntry No: _______ Payment Received:
__________________________________________________
Notes:
______________________________________________________________________________________
2015 SOLO ENTRY ONLY
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PLEASE SUBMIT ONE ENTRY FORM PER DISCIPLINE ENTERED.
CLASSNO
CLASSDESCRIPTION
NAMEPLEASE PRINT CLEARLY
DATE OFBIRTH
NAMEPLEASE PRINT CLEARLY
DATE OFBIRTH
ENTRYFEE
SUB TOTAL $
PLEASE ADD THE TOTAL OF THIS SECTION TO THE FRONT OF THE ENTRY
FORM.
CLASSNO
CLASSDESCRIPTION
GROUP NAME – (20 characters or less)PLEASE PRINT CLEARLY
How it is to be printed in Program
NO. IN GROUP(Schools only)
ENTRYFEE
SUBTOTAL $
PLEASE ADD THE TOTAL OF THIS SECTION TO THE FRONT OF THE ENTRY
FORM.
Entry form must be accompanied by FULL ENTRY FEE paid by
CHEQUE/MONEY ORDER made payable toCity of Dubbo Eisteddfod Inc. OR
DIRECT DEPOSIT to BSB: 932 000 ACC NO: 26026. Attach EFT receipt
with entry form.
2015 DUOLOGUES, DUOS, DUETS and TRIOS
2015 GROUPS
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CLASSNO
CLASS DESCRIPTION NAME OF ENTRANT(How it is to be printed in
program)
Number ofgroups to
be enteredin this class
Number ofperformers
in group
ENTRY FEE
9061 10 yrs/u TAP9062 12 yrs/u TAP9063 14 yrs /u TAP9090 Open
Tap9160 8 yrs Classical9161 10 yrs Classical9162 12 yrs
Classical9163 14 yrs Classical9190 Open Classical9290 Open
National
9361 10 yrs Contemporary9362 12 yrs Contemporary9363 14 yrs
Contemporary9390 Open Contemporary9461 10 yrs Modern9462 12 yrs
Modern9463 14 yrs Modern9490 Open Modern9560 8 yrs JAZZ9561 10 yrs
JAZZ9562 12 yrs JAZZ9563 14 yrs JAZZ9590 Open JAZZ9690 Open HIP
HOP9790 Open Entertainment
SUB TOTAL $
Entry form must be accompanied by FULL ENTRY FEE, paid by
CHEQUE/MONEY ORDER made payable to City of DubboEisteddfod Inc. OR
DIRECT DEPOSIT to BSB: 932 000 ACC NO: 26026. Attach EFT receipt
with entry form.
Office Use Only
Entry No: _______ Payment Received:
__________________________________________________
Notes:
_____________________________________________________________________________________
2015 DANCE TROUPES
