PIANO JURY FORM
(Complete this page and bring three copies to the jury)
Date: ___________________________
Name: ___________________________
Private Instructor: ___________________________ Semesters of Private Study ____
Check the following: Music Major: Yes ____ No ____
Piano Major: Yes ____ No ____
Freshman ____ Sophomore ____ Junior ____ Senior ____
List all technical exercises studied this term:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
List all repertoire studied this term and indicate by letter if the piece (A) was performed, (B) is
memorized, (C) is playable with score, (D) is just started:
Title Composer Letter
_____________________________________ ___________________________ _____
_____________________________________ ___________________________ _____
_____________________________________ ___________________________ _____
_____________________________________ ___________________________ _____
_____________________________________ ___________________________ _____
List accompaniments performed this term:
Title Composer
_____________________________________ ___________________________
_____________________________________ ___________________________
_____________________________________ ___________________________
Jury Grade _____ Signature ___________________________