Pedagogy Award Application Form Candidate Info Candidate's Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone (###) ### #### Completion date of written portion * MM DD YYYY Mark achieved * Must be 85% or above Institution * Canadian National Conservatory of Music Conservatory Canada The Royal Conservatory of Music Summary of Musical Training and Teaching * Teacher Info Teacher's Name * First Name Last Name ORMTA Branch * Teacher's Email * Teacher's Phone * (###) ### #### Waiver * By submitting this application, I confirm that the I give permission for ORMTA to publish the names and photos included in this submission. The text or image(s) submitted may appear in electronic form on the Internet or in publications outside the control of ORMTA and ORMTA shall not be held responsible for any consequences that may arise from such unauthorized reproduction. I agree Thank you for your submission! We will confirm with you and your teacher via email that your application was received. Your teacher will then also be asked to verify that they approve of your submission.