CJCB Registration & Payment Portal

Columbus Jazz Community Band Registration & Payment Portal

You have been selected to play in the next session of the Columbus Jazz Community Band. Congratulations! Please complete the registration form below to confirm your spot in the ensemble.

"*" indicates required fields

Thank you for registering for the CJCB! Participation in this program includes a $50 registration fee. Participating in a session of the CJCB for a semester is valued at $125, and we greatly appreciate any donation you may consider making on top of the registration fee. Please contact Mary Longsdorf, Education & Production Coordinator, at marylongsdorf@columbusjazz.org with any questions.

Participant's Name*

First Last

Primary Instrument*

Email*

Phone*

The following information is collected only for the purpose of documentation required by grant applications that support Columbus Jazz. This information does not have any impact on your ability to participate in our programs.

Ethnicity*

Gender*

Pronouns

Age

Are you under 18?*

Yes

Parent/Guardian Name (If Under 18)

First Last

Parent/Guardian Email

Parent/Guardian Phone

School Information (district, school, music teacher name & email, private instructor)

Mailing Address

Address*

Street Address City State ZIP Code

Please Select One:*

CJCB Donation

If you would like to donate to the Columbus Jazz to support the CJCB and other community programs in future semesters, please enter a contribution here. Thank you!

Total

Payment Method*

Credit/Debit

Check

Cash

I have received a scholarship for this program.

Credit Card

Cardholder Name

Card Details

Notes

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