Master Class – Application Form ~Prof Anna Gutowska~26th/2025 Venue: Abeno Kumin (Ward) centre Fee: JPY32,400 (50 min/lesson) Professor & Number of Lessons Anna Gutowska (Violin / Chamber Music) ---Select Number of Lessons---12 * Applicant Information Last Name * First Name * E-mail Address * Re-enter E-mail * To ensure our emails are delivered to your inbox, please add "osakaimc.com" domain to your safe senders list. Postcode Address * Mobile Phone Number * Phone Number Gender MaleFemale Date of Birth * (yyyy/mm/dd) Name of School GraduatedCurrent Grade —以下から選択してください—Year 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12 Date/Time Preferred Time First Choice: —以下から選択してください—10th 14:50~15:4010th 15:50~16:4010th 16:40~17:3010th 17:40~18:3012th 14:00~14:5012th 14:50~15:4012th 15:50~16:4012th 16:40~17:3012th 17:40~18:30 Second Choice: —以下から選択してください—10th 14:50~15:4010th 15:50~16:4010th 16:40~17:3010th 17:40~18:3012th 14:00~14:5012th 14:50~15:4012th 15:50~16:4012th 16:40~17:3012th 17:40~18:30 Repertoire * Composer: Title of Piece: Other Information Number of Visitors Applicant who is under 15 years old can be accompanied by one parent/guardian. Admission is limited to family members and their party. (Admission fee: JPY2,000/person) ---Select Number of Visitors---012 Final Round Participation I am a finalist.I do not participate in the competition. Remarks When the application has been submitted, an paypal invoice for the masterclass fee will be sent to the applicant via email.