Yamaha Clinics Application

Online Clinic Application

Yamaha Canada Music
Would you like to produce a clinic with a Yamaha Artist?

Use this form to tell us about your event, and Yamaha Canada Music will review it to determine whether we can provide financial support.
- This form should be used by educators, dealers, and event coordinators who regularly use Yamaha instruments.
- Requests must arrive at least 60 days prior to the scheduled event.
- Completion of this form does not guarantee a financial contribution from Yamaha Canada Music.
- You will receive a reply by email within 3-5 business days.
- This form must be filled out completely in order to be considered for support.
- We will only consider applications for clinics that will take place in Canada.
Event Information
Type of Event*

In-store ClinicHigh School Masterclass / ClinicUniversity Masterclass /ClinicProfessional ConventionRegional Music FestivalStart the GrooveOther
Event Date*

MonthDayYear
Event Name*
Event Location*

Location Name

Street Address Line 2

CityProvince

Postal / Zip Code
Number of Attendees*
Host / Contact Information
Host Name*

First NameLast Name
School, Institution, or Dealer Name*
Address*

Street

Street Address Line 2

CityProvince

Postal CodeCountry
Host E-mail*
Phone Number*

Area CodePhone Number
Clinician/Artist Information
Clinician/Artist Name*

First NameLast Name
Clinician/Artist E-mail*
Instrument*
Proposed Budget
Clinician Fee*
Travel Expenses (where applicable)
Other Expenses
Please explain "Other Expenses"
Contribution Information
Host Contribution*
Dealer Contribution*
Do you have any other contributors?

YesNo
Other Contributor Name 1
Amount of contribution
Other Contributor Name 2
Amount of contribution
Other Contributor Name 3
Amount of contribution
Total Amount Requested from Yamaha*
Participating Dealer Information
Dealer Name*
Contact Name*

First NameLast Name
City*
Province*
Dealer E-mail*
Phone Number*

Area CodePhone Number
Clinic Program Agreement
As the host of this event, you will agree to distribute literature provided by Yamaha Canada Music and/or the Clinician. You may also arrange with the dealer to display Yamaha instruments for student and customer trials.
Yes, I have read the agreement and, if funding is awarded, will abide by these requirements.*

Yes
Check the box below to agree and confirm that you've read our Privacy Policy and grant Yamaha Canada Music permission to contact you regarding your clinic application:
I agree and confirm
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Online Clinic Application

Event Information

Host / Contact Information

Clinician/Artist Information

Proposed Budget

Contribution Information

Participating Dealer Information

Clinic Program Agreement