CONTACT INFORMATION
*Required
Field |
| Band
Director: |
|
| *First
Name |
|
| *Last
Name |
|
*Program/
High School Name |
|
*Ensemble
Name |
|
| *Ensemble
Type
(Select the option
that best describes
your program) |
Public school
Private school
Community band
Arts magnet high school |
*School
Address:
(No P.O. Boxes) |
line 1 |
|
line 2 |
| *City |
|
| *State/Province |
|
| *Postal
Code |
|
| Country |
|
| *School
Phone |
|
| School
Fax |
|
| Home
Phone |
|
| *E-mail
Address |
|
*Have you received Essentially Ellington
materials
in the past?
Yes
No |
ADDITIONAL
QUESTIONS |
1.
How did you hear about Essentially Ellington?
Jazz at Lincoln Center website
IAJE or Jazz Educator's Journal
MENC, Teaching Music, or Music Educator's Journal
SB&O
Instrumentalist
Word of mouth
Other—please specify:
|
2.
Please provide a description of the racial/ethnic background of
students
from your school who benefit from the Essentially Ellington
program: |
| |
MEMBERSHIP LEVEL
During the 2007-08 academic year, Jazz at Lincoln Center will offer three tiers of membership in Essentially Ellington - Premium Membership, Basic Membership and Student Membership. These membership levels are aimed at giving as many high school jazz bands as possible the opportunity to receive the educational resources of Essentially Ellington (EE). For details on the repertoire and membership levels, please click here.
*Choose one:
• Premium Membership - $75 fee SOLD OUT!
Basic Membership - $45 fee
Student Membership - $25 fee |
| *Payment
method (funds must be in US dollars and, if possible,
drawn on a US bank): |
|
Check
(made payable to Jazz at Lincoln Center). Send to Essentially
Ellington, Jazz at Lincoln Center, 33 W. 60th Street, 11th
Floor, New York, NY 10023. Registration will be processed
upon receipt of check. |
|
|
Purchase
Order: fax your P.O. to (212) 258-9900, Attn: Essentially
Ellington. Registration will be processed upon receipt of
Purchase Order. |
|
|
Membership
Waiver Request: Please send a one-page letter on
school letterhead describing your financial situation by
fax to: (212) 258-9900 or by mail to Essentially Ellington,
Jazz at Lincoln Center, 33 W. 60th Street, 11th Floor, New
York, NY 10023. There are a limited number of waivers available,
and they will be awarded on a first come first served basis. |
|
|
Credit
Card—choose type:
American Express
Discover
MasterCard
VISA
|
| |
Credit
Card Number:
Exp. Date (mm/yy):
|
| |
Cardholder
Name (as it appears on card):
|
|
| ADDITIONAL
COMMENTS |
|
|
|