Colorado Jazz Ambassadors

Student Information

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Student's First Name *

Student's Last Name *

Student's PronounsHe / HimShe / HerThey / Them

Student's Email (if applicable) *

Confirm Email Address *

Student's Mobile Phone (if applicable)

Student's Primary InstrumentSelect Primary InstrumentAlto SaxophoneTenor SaxophoneBari SaxophoneTenor TromboneBass TromboneTrumpetPianoGuitarBassDrums / PercussionFluteClarinetVocalOther

Student's Secondary Instrument (if applicable)Select Secondary InstrumentAlto SaxophoneTenor SaxophoneBari SaxophoneTenor TromboneBass TromboneTrumpetPianoGuitarBassDrums / PercussionOther

Student's High School Graduation YearSelect HS Graduation Year202620272028202920302031203220332034

Student's Grade Level (upcoming school year)Select Grade Level5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th Grade

Student's School

Student's Birth Date

MonthSelect month123456789101112

DaySelect day12345678910111213141516171819202122232425262728293031

YearSelect Year212521242123212221212120211921182117211621152114211321122111211021092108210721062105210421032102210121002099209820972096209520942093209220912090208920882087208620852084208320822081208020792078207720762075207420732072207120702069206820672066206520642063206220612060205920582057205620552054205320522051205020492048204720462045204420432042204120402039203820372036203520342033203220312030202920282027202620252024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925

Parent's Street Address *

Parent's Apartment, suite, etc

Parent's City *

Parent's State/Province *

Parent's ZIP / Postal Code *

Student's Special Needs and Dietary Restrictions

Primary Parent/Guardian Information

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Parent/Guardian First Name *

Parent/Guardian Last Name *

Parent/Guardian PronounsHe / HimShe / HerThey / Them

Parent's Email *

Confirm Email Address *

Parent's Mobile Phone

Does Student live full-time at this address?Yes or NoYesNo

How often does Student live at this address?Select an OptionFull-TimePart-TimeLess than Part-Time

Secondary Parent/Guardian Information

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Secondary Parent/Guardian First Name

Secondary Parent/Guardian Last Name

Secondary Parent/Guardian PronounsHe / HimShe / HerThey / Them

Secondary Parent's Email

Secondary Parent's Mobile Phone

Does secondary parent live at the street address listed above?Yes or NoYesNo

Secondary Parent's Street Address

Secondary Parent's Apartment, suite, etc

Secondary Parent's City

Secondary Parent's State/Province

Secondary Parent's ZIP / Postal Code

How often does Student live at this address?Select an OptionFull-TimePart-TimeLess than Part-Time

Registration Information and Costs

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In which band would student prefer to participate?Choose BandIntermediate BandRocky Mountain All-Stars Jazz Band (Advanced Band – Audition Required))

Would you like to enroll your student for the full academic year, or just one semester?Students enrolled for the semester-only program may not be eligible to travel to festivals. A discount will be applied for full-year enrollment.Select an OptionFull Academic YearSemester Only

Which Semester?Choose SemesterFall Semester (September – January)Spring Semester (January – May)

Would you like to pay tuition up-front, or in equal monthly installments?A discount will be applied for full up-front payment.Select an OptionUp-FrontMonthly

CJA Advanced Full Year – Full Up-Front Payment

USD

CJA Advanced Full Year – Monthly Payment9 Equal Monthly Payments

USD

CJA Advanced Single Semester – Full Up-Front Payment

USD

CJA Advanced Single Semester – Monthly Payment9 Equal Monthly Payments

USD

CJA Intermediate Full Year – Full Up-Front Payment

USD

CJA Intermediate Full Year – Monthly Payment9 Equal Monthly Payments

USD

CJA Intermediate Single Semester – Full Up-Front Payment

USD

CJA Intermediate Single Semester – Monthly Payment9 Equal Monthly Payments

USD

Select Number of Monthly Payments – Summer CampSelect an OptionTwo Months @ $210 per month

Will student participate in out-of-state travel to festivals and/or competitions?Yes or NoYesNo

Would you prefer to pay for your student's travel up-front or over monthly installments?Travel is estimated at $1,200. A CJA representative will contact you to set up payment arrangements for summer travel.Select an OptionUp FrontMonthly Installments

Would you like to pay the full summer camp tuition up-front, or in monthly installments?A $25 discount will be applied for full up-front payment.Select an OptionUp-Front – $395Monthly – $420 total

CJA Summer Program – Full Up-Front Payment

USD

CJA Summer Program – Monthly Installments (four months)

USD

CJA Summer Program – Monthly Installments (three months)

USD

CJA Summer Program – Monthly Installments (two months)

USD

Total Due Today

$

CJA Tuition Payment *

Register for CJASave as Draft