Simpson College Jazz Combo Camp

June 7 -10, 2009

This form is a pre-registration form. You will not be registered for the camp until you send in your registration fee.

$295 Tuition/Room/Board - all classes, rehearsals, performances, 3 nights lodging in air-conditioned residence halls, and 10 meals in Pfeiffer Dining Hall
Please send a deposit in the amount of $50.00 payable to SIMPSON COLLEGE JAZZ CAMP. Indication that your check has cleared will serve as the receipt of application.
The remainder of the camp fee ($245) will be due when you check in at the camp.
If there are any problems, you will be notified immediately. Please feel free to contact Dave Camwell at 515-961-1575, or dave.camwell@simpson.edu, if you have any questions.

Please send $50 deposit to: Dave Camwell
Simpson College
Department of Music
701 North C Street
Indianola, IA 50125

Name:
Gender:	Male Female
Address:
City:
State:
Zip Code:
Home Phone:
Email:
Parent/Guardian’s Names:
School:
Director(s) Names:
Year of HS Graduation:
Primary Instrument:
Years of Study:
Secondary Instrument(s) (if applicable):
If you are a drummer, can you bring your own drum set?	Yes No
If you play bass guitar, can you bring your own amp?	Yes No
Do you currently take private lessons on your primary instrument?	Yes No
(Note: Private lessons are not a prerequisite for admission to the Simpson College Big Band Camp.)
Jazz Experience (ie, participation in school jazz ensemble, comfortable with improvisation, etc…):
What T-Shirt size do you wear?
What level of Theory are you comfortable with? (You can always change your level later.)
Rooming requests (cannot be guaranteed, but we'll try!):