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Jazz Girls Columbus Student Registration Form
Basic Information
Name
*
First
Last
Gender
Female
Non-binary
Other
Prefer not to say
Age
*
Would you prefer your pronouns are displayed on your nametag?
she/her/hers
they/them/theirs
ze/zir/zirs
No preference, please don't display pronouns
I'd prefer a different pronoun set and will provide them in the next field
Other optional pronoun choice
Please provide your preferred pronoun set if not listed on the previous field
Instrument
*
Email
*
Primary Phone
*
Secondary Phone
Mailing Address
Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
County
*
Please tell us the county in Ohio in which you reside.
Describe your experience in jazz.
This could include playing in a jazz ensemble, taking lessons, attending a collegiate music program, etc.
Are you planning on auditioning for All-State or the Columbus Youth Jazz program?
Select All
All-State
Columbus Youth Jazz
I’m not sure
No, I’m not planning on auditioning
Select all that apply
Shirt size
XS
S
M
L
XL
2XL
3XL
All participants will receive a free Jazz Girls Columbus shirt.
School Information
Grade
*
6th
7th
8th
9th
10th
11th
12th
College Student
School Name
*
School District
Band / Jazz Band Director
*
Band Director email
*
Private Instructor
Private Instructor email
Parent/Guardian Information
Parent/Guardian Name
*
First
Last
Required if student is a minor
Parent/Guardian Email
*
Parent/Guardian Phone
*
Parent/Guardian Address (if different than student address)
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Suggested Donation
The Jazz Academy program is available to everyone at no cost, though we estimate its value at $100. Your participation is invaluable in sustaining these initiatives for the future, and we’re sincerely grateful for your support.
Releases and Permissions
Photo Release
*
I understand that there will be occasions that photos and videos are taken of the Jazz Girls Columbus and its participants for promotional and documentation purposes, and by signing the application form, furnish permission for me/my minor child’s likeness to be used for the above-mentioned purpose.
CAPTCHA
Total
$0.00