Illinois Music Association 2026
Self Accompaniment Registration Form
Teacher/Studio Name
*
First Name
Last Name
Teacher/ Studio Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Teacher/ Studio Email
*
example@example.com
Teacher/ Studio Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I have read the Rules and Registration Information found on the Illinois Music Association Website (link below). Please review your registration information carefully. No changes will be allowed once your registration is submitted.
*
Yes
Rules
Registration Information
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Student 1 Name
*
First Name
Last Name
Student 1 Age
*
Student 1 Select your accompaniment instrument
*
Piano
Ukulele
Guitar
Student 1 Name of song
*
Student 1 Composer or artist if known (not required)
Student 1 Day Selection
*
Saturday Mandatory
Submit a 2nd student? (Press Next after your selection)
Yes
No
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Student 2 Name
*
First Name
Last Name
Student 2 Age
*
Student 2 Select your accompaniment instrument
*
Piano
Ukulele
Guitar
Student 2 Name of song
*
Student 2 Composer or artist if known (not required)
Student 2 Day Selection
*
Saturday Mandatory
Submit a 3rd student? (Press Next after your selection)
Yes
No
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Next
Student 3 Name
*
First Name
Last Name
Student 3 Age
*
Student 3 Select your accompaniment instrument
*
Piano
Ukulele
Guitar
Student 3 Name of song
*
Student 3 Composer or artist if known (not required)
Student 3 Day Selection
*
Saturday Mandatory
Submit a 4th student? (Press Next after your selection)
Yes
No
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Next
Student 4 Name
*
First Name
Last Name
Student 4 Age
*
Student 4 Select your accompaniment instrument
*
Piano
Ukulele
Guitar
Student 4 Name of song
*
Student 4 Composer or artist if known (not required)
Student 4 Day Selection
*
Saturday Mandatory
Submit a 5th student? (Press Next after your selection)
Yes
No
Back
Next
Student 5 Name
*
First Name
Last Name
Student 5 Age
*
Student 5 Select your accompaniment instrument
*
Piano
Ukulele
Guitar
Student 5 Name of song
*
Student 5 Composer or artist if known (not required)
Student 5 Day Selection
*
Saturday Mandatory
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Registration Fee to be paid by Credit Card or PayPal
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( X )
IMA Member
$
37.00
Quantity
1
2
3
4
5
6
7
8
9
10
Non Member
$
42.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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