Student's Name:

Age: (if under 18)

Sex: Male aaaa Female

School:

Grade (i.e. 7th, 8th, etc):

Type of Saxophone that you play (Soprano, Alto, Tenor, Baritone):

Years of study on your instrument:

Private Instructor:

Band Director:

Parent/Guardian:

Mailing Address (street, city, zip):

Primary Phone:

Alternate Phone:

Email:

REGISTRATION:

I would like to register for the Saxophone Workshop, including room and board at Stetson University: $385

I would like to register for the Saxophone Workshop, including lunch and dinner at Stetson University (local students only): $285

I can bring a Soprano, Tenor, or Baritone Saxophone?

If you can bring a saxophone, list which type (Soprano, Tenor, or Baritone):

I would like to purchase a t-shirt for $10

T-Shirt Size

S aaaa M aaaa L aaaaXL

If you have a room mate that you would like to be assigned, enter their name in the space provided:

Comments or Questions: