Registration- Jazz Piano Workshop

Your Name*
First Last
Age*
School*
Grade Level*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name of Parent/Guardian*
First Last
Parent/Guardian Email*
Parent/Guardian Phone*
How many years of piano instruction (classical or jazz) have you had?*
How many years of jazz piano instruction have you had?*
How many years of experience do you have playing jazz piano?*
How much experience do you have playing jazz piano in a band or ensemble?*
Do you have knowledge of basic jazz standards?*
Do you know basic jazz voicings (Cm, C7, Cm7b5)?*
Do you know major and minor scales?*
Do you have knowledge of scales appropriate for each chord (scales over changes)?*
Do you have the ability to play a 12-bar blues?*
How did you hear about this workshop?*
Do you have a request for group placement? Leave this field blank if you would like us to place you based on your answers above.
Please list any food allergies or dietary restrictions
Name of current Piano Teacher and/or Jazz Piano Teacher (if applicable) and any Additional Information

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