Jazz Festival Entry Form

Please register by October 25, 2012. You can register after this date, but the sooner, the better. Thanks!

Indicates a Required Field

School Name:

Ensemble:

Director's Name:

Director's Email:

School Address:

City:

State:

Zip:

Phone Number:

Instrumentation (Enter # of students) Bass Guitar:

Instrumentation (Enter # of students) Bb:

Instrumentation (Enter # of students) C Bass:

Instrumentation (Enter # of students) C Treble:

Instrumentation (Enter # of students) Drummer:

Instrumentation (Enter # of students) Eb:

Instrumentation (Enter # of students) Guitar:

Instrumentation (Enter # of students) Piano:

Evening Concert (# of reserved seats needed):

Choose one of the following options:

Clinic: $80/Band (workshop and concert included)

Workshop: $10 per student (concert included - $80/max per school)

Comments:

Verification Code:

If you are not sure what the words are, enter your best guess.

Please make checks payable to Iowa Lakes Music Department.

Return to:
Carol Ayres, Iowa Lakes Jazz Festival
Iowa Lakes Community College
300 S. 18th Street
Estherville, IA 51334

Fax Number: 712-362-8363
Email: cayres@iowalakes.edu