Personal Information Applicant’s Name (Last, First) Other Names Used Age Sex Parental Information Parents or Guardians Name (Last, First) Address City State Zipcode Home Phone Work PhoneCell Phone Email Address Educational Information Do You Have A Private Instructor? YesNo If yes who? School Currently Attending School Zip Code What is your primary instrument? How Many Instruments Do You Play? What are they? Musical Experience Musical Awards Have You Ever Been In The Summer Jazz Workshop YesNo If yes, When? What Do You Expect To Gain From The Workshop? How Did You Hear About The Summer Jazz Workshop? Will You Be Able To Spend The Entire 4 Weeks in The SJW? YesNo If No, please explain: What Are Your Music Goals? Have You had Training in Jazz Before? Can you read musicYesNo? Medical Information Do You have any medical conditions that the Summer Jazz Workshop Staff should be aware of? If yes, please explain: SJW Site Trinity Episcopal Church Campus 1015 Holman St Houston, TX. 77004 T-Shirt (T-shirts are adult sizes) SmallMediumLargeX-Large2X-Large Optional Question Would you be interested in other playing opportunities after the Summer Jazz Workshop? Please prove you are human by selecting the Flag.