SSI: Application

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Summer String Institute

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I certify that as the individual filling out this form, I am 18 years or older.

Yes I agree.

How are you (the purchaser) related to the student?

Student Type

The student is a minor

The student is an adult

Student's Information

First Name:

Last Name:

Gender Identity:

Date of Birth: (MM/DD/YYYY)

Name of School: (if applicable)

Grade as of September 2025:

By providing the student's email you, parents/guardians, consent to allow the National Philharmonic to contact the student regarding any SSI communications.

Student Email:

Pronouns:

Ethnicity:

Asian

Black/African American/African

Middle Eastern

Native American/Indigenous

Native Hawaiian or Other Pacific Islander

White/Caucasian

Multi-Racial

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Please select your Student's t-shirt size:

Instrument:

Length of time played:

Enter the number of years the student has played this instrument.

Has the student ever attended SSI before?

Please provide a list of not more than 10 pieces that you have performed this school year. Please include the name of the composer as well.

Which SSI level/ensemble are you applying? Please make sure to review the audition requirements for each ensemble thoroughly.

Please submit the link to one unedited Youtube video of your recorded audition that includes the required scales and excerpt (in that order) for the ensemble for which you are applying.

Which sessions does the student wish to attend?

Teacher Contact Information

(Private teacher or schoolteacher who will write a letter of recommendation)

Teacher Name:

Teacher Phone #:

Teacher Email:

How did you hear about Summer String Institute?

Parent/Guardian Information

Relationship to Student:

Name

Address:

City:

Country

State/Prov:

Postal Code:

Best phone to reach primary guardian or student

Primary Phone Number:

Best email to reach primary guardian or student

Primary Email for all SSI communication:

Second Parent/Guardian Information

Relationship to Student:

Does the Second Guardian reside at the same address as the Primary Guardian?

Name:

Second guardian's Phone Number:

Second guardian's email address:

Emergency Contact Information

Relationship to Student:

Emergency Contact Name:

Emergency Contact Phone:

Second Emergency Contact Information

Relationship to Student:

Second Emergency Contact Name:

Second Emergency Contact Phone:

Medical Information

Physician Name:

Physician Phone Number:

If the student has severe allergies that we should be aware of, please list them below. If you plan to leave an Epipen during class times, please indicate below.

Does the student regularly take any medications that we should know about? If yes, please list below. If no, please write 'none'.

We can make the camp more successful for everyone when the teacher is aware of challenges ahead of time.
Are there any concerns (behavioral, reading, developmental, cognitive, etc.) we should be aware of before class starts? Please provide specific details. Please provide any notes that would be helpful for us:

It is okay to contact the student and guardians at the above phone numbers about future opportunities:

Waiver
MEDIA RELEASE: Unless informed otherwise in writing to my Student's teacher, National Philharmonic may use student photos, video footage and student quotes in print and electronic publications, on social media, and in media coverage of National Philharmonic programs. I acknowledge that National Philharmonic takes cautionary steps to provide minimum identifying information.
Yes I understand and accept the above Media Waiver.
MEDICAL WAIVER: In the event of serious illness or injury, I authorize the staff of National Philharmonic to act as my agent in obtaining medical care for the student(s) listed on this form. I understand that I will be contacted using the information I have provided above.
Yes I understand and accept the Medical Waiver.
I have read, understand, and accept National Philharmonic's Refund Policy.
Yes I agree.
I have read, understand, and accept all of the National Philharmonic Camp Policies and Procedures and am aware that they are strictly upheld by National Philharmonic.
Yes I agree.
Please provide any additional notes, comments, or questions about your SSI application.

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Available Groups

Available Sections

Application Fee $100.00

Application Fee $100.00

Student's Information

Length of time played:

Teacher Contact Information

Parent/Guardian Information

Second Parent/Guardian Information

Emergency Contact Information

Second Emergency Contact Information

Medical Information

Waiver

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Application Fee $100.00

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Student's Information

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Teacher Contact Information

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Second Emergency Contact Information

Medical Information

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