Memphis Jazz Workshop Fall 2021 Registration
Please complete the following form in order to register for the FALL 2021 Memphis Jazz Workshop. Then follow the payment link below.
The MJW Workshop Dates are as followed:
Saturday’s Sept 11th-Dec 11th 2021 from 9am-1pm, Location: Hutchison School 1740 Ridgeway Road, Memphis, TN 38119

September
11th
18th
15th
25th

October
2nd
9th
23rd
30th

November
6th
13th
20th

December
4th
11th-Final Performance


Classes Offered
Beginning Improv, Piano, Harmony, Masterclasses and Combo
Intermediate Improv, Piano, Harmony, Masterclasses and Combo
Advanced Improv, Piano, Harmony, Masterclasses and Combo

To pay your fall workshop tuition, please use the link below.
Tuition is $500/ 41.66 per Saturday Session

https://checkout.square.site/merchant/D7790D9PJCPX9/checkout/DUGCTV65TCS6IPMTIGRYMG23

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Email *
Student First and Last Name *
Student Email *
Student Phone Number *
COVID 19 Acknowledgement: Must be electronically signed by parent if student is under the age of 18. The Memphis Jazz Workshop will do its best to honor and implement the proposed schedule for the Fall 2021 semester.  Shelby County Health Department directives will be followed and the schedule may need to be modified.  Please check the box to affirm. I acknowledge that the Memphis Jazz Workshop may need to adjust the schedule for dates/times to ensure the safety of my student. *
Required
Parent 1 First and Last Name *
Parent 2 First and Last Name
Parent 1 Phone Number *
Parent 1 Email *
Street Address *
Zip Code *
City *
Parent 2 Phone Number
Parent 2 Email
Primary Instrument *
How many years have you played your primary instrument? *
Ownership of Instrument *
Piano Skills (Select one that best describes your current skill level.
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Do you take lessons, if so how many years of  private lessons?) *
Scales I can play on piano. Check all that apply! *
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Clefs I can Read (Check all that apply) *
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School Name *
Grade Level *
How did you hear about us?
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Electronic Signature and Date
Please type your name.  Your electronic signature is being recorded and must be completed by an adult over the age of 18.  After typing your name, enter today's date.
Parent/ Legal Guardian Consent *
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Signature (Type Full Name) Parent or student 18+ *
Date (Select today's date) *
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A copy of your responses will be emailed to the address you provided.
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