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Application for Loan of Instrument- Nippon Music Foundation ☐☐

Mr.

☐Ms.

OthersName:First/Middle/Last

Address:

Mobile:Home Phone:

Email:

Fax:

Date of Birth:

Nationality:
Date/Month/Year

Age*:*Letter of Legal Guardian to be accompanied for applicants 19 or under

Requested☐

Loan Category

A

Requested Loan

☐

B☐

C

Start

Period:Years

Date/Month/Year

NOTE:
Loan Category

Length of Loan

EligibilityA

2-7 years

Applicants who are age 35 or under as of September 1st of theapplication year (Quartet: the average age 40 or under)B

2-3 years

Applicants who are performing mainly in Japan.
Applicants who are age 35 or under as of September 1st of theapplication year. (Quartet: the average age 40 or under)C

Up to 1 year

Applicants who have a specific purpose of activities(e.g. Recording, Competition, Anniversary Concert,Special Concert, Debut Concert etc.)
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Purpose of Loan
Describe your eligibility for the loan as well as your career goals, and how the loan helps your development and achieve
your goals. Specify Concert/ Recording/ Competition during your requested period.
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Education
School (current or last):
Course:Degree☐☐Currently Attending
Graduated

Expected Year of Graduation:
Year of Graduation:

Tutors & Teachers (choose three if there are more):
Name:
Period:Name:
Period:Name:
Period:Awards & Scholarships (choose up to three):
Name:
Year:

Name:
Year:

Name:
Year:

Name:
Year:

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Instrument Information
Specify the instruments you have used and currently using in reverse chronological order.
1. Owner of Instrument:
Instrument(Name, Year, Maker):Start:End:
Month/Year☐Month/Year

Currently Used

2. Owner of Instrument:
Instrument(Name, Year, Maker):Start:End:
Month/Year☐Month/Year

Currently Used

3. Owner of Instrument:
Instrument(Name, Year, Maker):Start:End:
Month/Year☐Month/Year

Currently Used

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Performance Highlights (choose three concerts you feel most notable):
Date:
Place:
Performers:

Date:
Place:
Performers:

Date:
Place:
Performers:

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Latest Released Recordings (if applicable):
1. Label:Released Date:
Program:
2. LabelReleased Date:
Program:
3. Label:Released Date:
Program:

Latest Online Music Streaming (if applicable)
1. Platform:
URL:
Program:

2. Platform:
URL:
Program:

3. Platform:
URL:
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Management (If applicable)
Agency Name:
Contact Person:
Address:

Telephone:

Fax:

Email:

Agency Name:
Contact Person:
Address:

Telephone:

Fax:

Email:

Agency Name:
Contact Person:
Address:

Telephone:

Fax:

Email:

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Attachment
1. Two Recommendation Letters
NOTE: (1) Letters must be written in English.
(2) Letters without a signature of the recommender are not acceptable.
(3) Letters must be addressed to Nippon Music Foundation.
(4) Extra letters are not acceptable.
(5) Letters must not be directly sent to the Foundation(6) (QUARTET) Two recommendation are required for a quartet.

1.

Name:
Occupation:
Address:

Telephone:2.

Email:Name:
Occupation:
Address:

Telephone:

Email:

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2．Three Audiovisual Recordings of Your Playing☐☐Recordings uploaded to online file storage services
Recordings sent by DVD or USB by mailNOTE: (1) Submit 3 separate recordings selected from the repertoire as listed in the Application
Guideline (Category A, B) or 3 separate recordings of your choice regardless of therepertoire as listed in the Application Guideline(Category C).
(2) The recordings must be made within the last 12 months from the start date of Application Period.
(3) The recordings must clearly show the applicant’s hands and face.
(4) The recordings must be uploaded to online file storage services or submitted by themultimedia file formats viewable with Windows Media Player 12.
The files can be sent by DVD or USB.
The links for video streaming sites such as YouTube are not acceptable.
Video format for DVD is acceptable.
(5) Do not directly send the files by email.
(6) Poor sound or visual quality recordings may not be accepted.

1. Composer:
Title:
Movement &Start Time ofEach Movementin Recording:

1stStart Time

2ndStart Time

3rd

Start Time

4thStart Time::::Recording date/year:Recording place:
Orchestra,Conductor, Pianist:
URL:

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2. Composer:
Title:
Movement &Start Time ofEach Movementin Recording:

1stStart Time

2ndStart Time

3rdStart Time

4th

Start Time

1stStart Time

2ndStart Time

3rd

Start Time

4th

Start Time::::

Recording date/year:
Recording place:
Orchestra,Conductor, Pianist:
URL:

3. Composer:
Title:
Movement &Start Time ofEach Movementin Recording:::::

Recording date/year:
Recording place:
Orchestra,Conductor, Pianist:
URL:

3.

Biography

4.

Performance Schedule of the Past One Year and the Next One Year

5.

Performance Repertoire

6.

Photography

7.

Letter of Legal Guardian (for applicants 19 or under)

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DECLARATION

1.

I have read the eligibility criteria which are described in the Nippon Music Foundation’s website, and I meet thesecriteria.

2.

I have carefully read the Loan Agreement and the Memorandum for ATA Carnet available on the Nippon Music
Foundation’s website and will abide by their terms and conditions if I am a recipient of the Instrument.

3.

I pledge that the application materials I submit are true and correct.

Applicant’s Name (print):
Signature:
Date of Application:
Date/Month/Year

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