Fill in the information and mail to:
Pasadena Jazz Institute
260 E. Colorado Blvd. Suite 206
Pasadena CA. 91101
(626) 398-3344

Fill in the form on this page before printing it out.

Which session will your child attend?  All sessions meet Sunday's, January 13th --March 30th 2008

Combo #1, Sunday 11:00 am - 12:30 pm Jr. Jazz Orchestra, Sunday 1:00 pm -- 2:30 pm.

Student's Last Name    First Name    Age
Street Address   City   Zip
Email address   Home Phone
Parent's Name Parent's Work Phone  

JAZZ CLASSIFICATION

Instrument   Years Played  

                     Beginner Level   Intermediate Level   Advanced Level

Jazz Experience 

Parent's Signature ______________________      Application Date