Kanack Chamber Music, Fiddle/Folk/Bluegrass Bands, and Jazz Band Registration
fill out this form to be placed in a group or multiple groups.
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Email *
Student's First Name *
Student's Last Name *
Date of Birth
Age (or Adult) *
Parents/Guardians Name and Occupation (For Adult Students please list occupation) *
Street Address *
City *
Zip Code *
additional e-mail (if multiple, please separate by a comma):
Primary Phone # *
Primary Phone Type *
Alternate Phone #
Alternate Phone Type
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Instrument(s): *
Private Teacher: *
Most Recent Solo Piece: *
Note-Reading Experience: *
What Chamber Music or Band experience do you have? *
If there are other musicians you would like to be placed with, please list them here:
Please check which type of ensemble(s) you are interested in.  You will be able to detail preferences in the next question if you choose more than one. *
If you selected multiple options above, please specify if you would like to be placed in multiple groups, if you would like to be placed in one and what you first choice would be, or if you would like to be placed in one group that combines the different styles (if possible).
Repertoire Requests?
Please select the level you would like to register for.  Your level may be adjusted due to availability of other members, coaches, or rooms. *
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