Columbus Jazz Girls Ensemble Registration

Basic Information

Name*

First Last

Please describe your experience with jazz.*

What is your comfort level with improvisation?*

I plan to attend the Jazz Girls Columbus event on April 18*

Primary Instrument*

Please explain

E.g. "I play bari and tenor" "I play electric and upright bass" "I also play trombone"

Email*

Primary Phone*

Secondary Phone

Mailing Address

Address*

Street Address City State ZIP Code

County*

Please tell us the county in Ohio in which you reside.

Personal Information

The below information is collected only for the purpose of documentation required by grant applications that support the Jazz Arts Group. It will not affect your eligibility for participation in the Youth Jazz program.

Age*

Ethnicity*

Gender*

Preferred Pronouns*

School Information

Grade*

School Name*

School District*

Band / Jazz Band Director*

Band Director email*

Private Instructor*

Private Instructor email*

Parent/Guardian Information

Does your student have reliable transportation?

Yes, myself or a family member/guardian will be transporting them

Yes, they will be driving themselves

No, they need carpooling

I'm not sure yet

Saying yes or no does NOT influence your student's placement or participation in this program. This just allows us to assist in coordinating a carpool if needed.

Parent/Guardian Name*

First Last

Parent/Guardian Email*

Parent/Guardian Phone*

Parent/Guardian Address (if different than student address)

Street Address City State ZIP Code

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Basic Information

Mailing Address

Personal Information

School Information

Parent/Guardian Information

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