The World is Watching...

Violin Maker Registration Form

21st Century Violin Search
Violin Maker Registration Form

Registration form confirmation

Upon completing the registration form, you will receive a confirmation email from IVCI.

If you have a problem submitting the registration form or do not receive a confirmation email, please contact Mindy Miller.

Name *
Address *
City *
State *
Zipcode *
Country *
Email *
Best Contact Number   *
Date Instrument was completed *

I wish to register a violin in the International Violin Competition's 21st Century Violin Search for the 2018 Competition.
I certify and agree as follows:

I certify that the submitted instrument was made after January 1, 2001 and that I am the primary maker of the instrument.

I agree that the submitted instrument is available for sale.

The sale price of the violin (must be in line with current market value of maker’s instruments) is: * $

I release and hold harmless the International Violin Competition of Indianapolis from any and all liability and responsibility for my instrument due to loss, damage, or destruction during the Search. I understand that I am responsible for insuring my own instrument and all shipping charges.

I understand that my instrument will not be available for pick up prior to 2:00 PM on Sunday, September 16, 2018.

I have read and accept all the rules and regulations of the Search.

Date  
Printed name *

By checking the electronic signature and acceptance box below, I agree and consent that checking the signature and acceptance box constitutes my electronic signature, acceptance, and agreement to the matters contained in this Application, and that my electronic signature has the same force and effect as my handwritten signature.

Applicant's electronic signature and acceptance *
Payment Information
$200.00 USD
A valid Credit Card is required to process your application.
Type of CC: *
CC Number: *
Expiration Date: * (mm/yyyy)
Name on CC: *
CVV Code: * What is this?
Find your security code

The security code is issued with all MasterCard, Visa, Discover, and American Express. It is used as an additional means of protection against fraud, and helps us validate your information.

MasterCard and Diners Club
The 3-digit, non-embossed number is printed on the signature panel on the back of the card.

Visa
The 3-digit, non-embossed number is printed on the signature panel on the back of the card — immediately following the Visa card account number.

Discover
The 3-digit, non-embossed number is printed on the signature panel on the back of the card — immediately following the Discover card account number.

American Express
The 4-digit, non-embossed number is printed above your account number on the face of your card.

 
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