University of Arizona Jazz Workshop Series Application
Monday, June 10, 2019 - Thursday, June 13, 2019
Email address *
Fred Fox School of Music
Applicant Legal LAST/Family/Surname *
Your answer
Applicant Legal FIRST/Given Name *
Your answer
Gender *
Your answer
Age *
Your answer
Birth Date *
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DD
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YYYY
Permanent Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Which category do you fall into? *
Major Instrument *
Your answer
Have you been a member of All State and/or All County Band? *
Your answer
Do you have any food allergies or restrictions that we should be aware of? *
Your answer
Do you have any medications that you will be bringing to the jazz workshop series? *
Your answer
Participant Cell Phone Number *
Your answer
Retype Participant Email Address *
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian Email Address *
Your answer
Retype Parent/Guardian Email Address *
Your answer
How did you hear about the University of Arizona Jazz Workshop Series? (flier, friend, band director, season brochure advertisement, etc.) *
Your answer
Consent: Photography Release - I hereby authorize the University of Arizona, or anyone authorized by the university, to use and reproduce any and all photographs that have been taken of me during my time on the campus without compensation to me. All photographic files, together with the images (both digital and printed), are owned by the Fred Fox School of Music. Images and names may be used. The University of Arizona Jazz Workshop Series reserves the right to use these photographs in any of its print or electronic formats, as well as to accompany news releases. (Parents or Guardians of participants younger than 18 years of age must complete this section.)
Emergency Contact Name *
Your answer
Emergency Contact Relationship to Applicant *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Email Address *
Your answer
Camp Tuition - The $175 Camp tuition provides participation in workshop classes/rehearsals and the performance in the final concert on June 13th. A check must be made out to the "University of Arizona" to complete registration. By clicking this button, it is an agreement that you will be committing. *
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A copy of your responses will be emailed to the address you provided.
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