Financial Aid/
Work Exchange

I am applying to: *

Jazz Camp West

Jam Camp West

Camper Name *

Name

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gender *

Male

Female

Other

Phone (day) *

(###)

###

####

Phone

(###)

###

####

Are you a *

Are you a

Instrumentalist

Vocalist

Dancer

Any eating restrictions?

Vegetarian

Gluten Free

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)

I have received a scholarship in the past

Yes

No