Readmission Application - Puerto Rico Conservatory of Music

I. PERSONAL DATA

Readmission Request for the semester

Date: *

Last name: *

Mother's last name: *

First Name: *

Student number *

Postal address: *

Residential address: *

Residential telephone: *

Cell phone:

Email *

Date of birth: (month / day / year) *

Place of birth: *

Gender:

Civil status:

Citizenship: *

Occupation:

Type of visa:

If you are a permanent resident, please indicate your resident card number:

Study program *

Indicate the specialty to which you wish to be readmitted. Select one only.

Specify Instrument

Preferred teacher (subject to availability):

Did you study outside the Puerto Rico Conservatory of Music? *

If you answered YES, please indicate the name of the institution and courses taken:

IMPORTANT:

I CERTIFY BY THIS MEANS

Signature of the applicant: *

Signature of parent or guardian: (If the student is a minor)