PSE Application "*" indicates required fields Student InformationStudent Name* First Last Preferred NameInstrument* Violin Viola Cello Bass Piano Flute Clarinet Oboe Number of Years Playing Instrument*Student Age*Which of the following most accurately describes you?*FemaleMaleNon-binaryTransgenderNot listed (please state)I prefer not to saySelect as many options as applicableGender self descriptionWhat are your pronouns?Select an optionShe/her/hersHe/him/hisThey/them/theirsNot listed (please state)I prefer not to sayThis helps us understand the best way to address you. For example, choose “She/her” if you would like us to say “She’s celebrating her birthday today!” on your birthday.Pronoun self descriptionStudent's School (2025-2026 School Year)*Grade (2025-2026 School Year)*T-Shirt Size (Adult Only)* Small Medium Large Extra Large Other Parent InformationParent's Name* First Last Parent's Phone*Parent's Email* Student's Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Teacher InformationName of Private Teacher* First Last Teacher's Email* Teacher's PhonePlease have your teacher complete the online Teacher Recommendation Form by February 27th. Teacher Recomendation Form Delivery* Automatically email the Teacher Recommendation Form to my private teacher at the email address I provided above when I submit this form. I will deliver the teacher recommendation form to my private teacher myself. All Applicants Answer the Following Question:How did you hear about us?*This field is hidden when viewing the formWhy would you like to enroll in this workshop?Please Answer the Following Questions or Submit a Student Resume and/or BiographyWhat is your experience with playing chamber music?Please list chamber music works that you have studied and/or performed:Resume/Biography Upload Drop files here or Select files Accepted file types: doc, docx, rtf, pdf, , Max. file size: 64 MB. File types allowed: .doc, .docx, .rtf, and .pdfPSE RepertoireWould you like to play a chamber piece from a 20th or 21st century composer? Yes No Let us know if there is something specific you would like to play.Audition Alternative I will NOT be able to submit a video audition. Please contact me regarding an alternative. Photo/video Image Release* Yes, I accept the below terms and conditions for photo/video image release (call MYS office with questions) I do NOT accept the below terms and conditions for photo/video image release. I give Portland Summer Ensembles (PSE) permission to photograph, and record video and audio images of the musician while participating in any PSE activity. I understand these images and recordings may be used by PSE to promote PSE and/or its musicians. I agree that neither I nor the musician will receive compensation for PSE’s use of such images or recordings.WAIVER, RELEASE AND AGREEMENT* Yes, I accept the below terms and conditions (call MYS office with questions) No, I do not accept the below terms. I hereby waive, release, discharge and agree to hold PSE/MYS and its officers, employees, directors and volunteers harmless from and against any and all claims, damages, injuries, or liability of any nature arising from or related to participation of the musician in any PSE/MYS activity, including but not limited to rehearsals, performances, and other activities, including without limitation those arising out of or attributable to exposure, infection, and/or spread of COVID-19 or any variant thereof. 2. Consent to medical care. As parent or guardian of the musician, in the event of a medical emergency in my absence, I authorize PSE/MYS to obtain medical care for the musician, including consent to administration of drugs or anesthesia, medical procedures, evaluation and treatment. I agree to indemnify PSE/MYS for any medical expense incurred by PSE/MYS in connection with the musician, whether or not it is reimbursed by my insurance.NameThis field is for validation purposes and should be left unchanged.