Please Note: This application is used for 2 Living Jazz programs, Jazz Camp West and Jam Camp West. Please make sure to check carefully which program you are applying to.

Jazz Camp West Applications for financial aid are closed as of May 15!

I am applying to: *

Jazz Camp West

Jam Camp West

How did you hear about Jazz Camp West? *

Please answer as specifically as possible. This helps us with our outreach efforts!

Camper Name *

Name

First Name

Last Name

Name of parent or guardian (if under 18) *

Email *

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gender *

Male

Female

Other

Age *

How old will attendee be the first day of the event?

If under the age of 18, what is the attendee's date of birth?

Phone (day) *

(###)

###

####

Phone

(###)

###

####

Ethnic Background *

Are you a *

Are you a

Instrumentalist

Vocalist

Dancer

For our summer camps only: *

Are you an instrumentalist, dancer or vocalist? If Instrumentalist, which instrument do you play?

For Jam Camp application only:

If currently a student, what school do you attend?

If currently a student, what grade will the camper be in the upcoming fall?

JAM Camp only - Optional: choice of roommate

Any eating restrictions?

Vegetarian

Gluten Free

Housing Consideration (Jazz Camp Only) *

We have a limited number of scholarship space with cabin housing. In the instance that we are at capacity of cabins, are you willing to camp on site instead? (We have rental camping gear available)

Housing *

If you are you applying for Jazz Camp, the adult program, would you prefer:

Thelonious Monk Cabin

Camping

NA - Im applying for Jam Camp (Youth)

Roommate

Any roommate preference? If so, please list full name.

Number of people in household supported by wage earners

Salary/wages of primary earner

Rental Income/interest

TOTAL INCOME *

UNUSUAL EXPENSES

(complete fields below)

Medical

Other

Number of Dependents

Projected Income for current year *

Estimate of what I can pay towards fees *

For Jazz Camp West and Jam Camp West Only Please Note: In most cases, awards help with camp tuition only but not the cost of room and board. Please keep this in mind when projecting what you estimate you can pay. Most awards range between $500-$800 depending on each individual's situation.

I have received a scholarship in the past

Yes

If so, which years?

For all programs: *

Please explain your need for assistance. Write a brief explanation of your current financial situation, why you need financial aid, why you want to come to camp and if you have any special skills you can offer us during the week at camp (Not more than a few paragraphs).

Thank you for your submission!

You will receive an email from our staff regarding the status of your application. Please feel free to email us with any questions at info@livingjazz.org.