For detailed information about where and when the workshop will take place as well as driving directions and consent form please click here; INFORMATION

To register, print this page (click "file";select "print") fill it out and mail it along with a $100, non-refundable, tuition
deposit to:

Seattle Jazz Workshop
2110 N 150th St.
Shoreline, WA 98133

The tuition deposit will hold a students position in the enrollment. The balance, $300, must be paid by
June 15, 2010 or the student will be moved to the waiting list, possibly losing their place at the workshop. Total tuition will equal $400.

Checks should be made payable to: Seattle Jazz Workshop

Enrollment is based on a first-come, first-served basis. Those who complete tuition payments first will be
guaranteed positions in the workshop, provided that enrollment has not been exceeded.

--------------------------------------------------------------------------------

STUDENTS NAME_______________________________________________________AGE____________

PARENT OR GUARDIAN (FIRST, LAST)_____________________________________________________

ADDRESS______________________________________________________________________________

CITY__________________________________________STATE__________ZIP______________________

DAYTIME PHONE_______________________________EVENING PHONE_________________________

E-MAIL________________________________________________________________________________

STUDENT'S SCHOOL____________________________________________________________________

INSTRUMENT___________________________________________________________________________

Once registration materials have been received, an e-mail confirmation will be sent to you. If you have not
received a confirmation from the workshop within one week of mailing your registration, please contact
Steve Korn at:StvKrn@comcast.net.