Casper College Form Central

Registration Form

* required fields

School Name*:

Mailing Address*:

City*:

State*:

Zip Code*:

Phone*:

Fax*:

Email Address*:

Director*:

Ensemble Name*:

Ensemble:	Instrumental Combo
	Big Band
	Vocal
School:	Jr. High or Middle School
	High School

PERFORMANCE DAY & TIME PREFERENCE

The Kinser Jazz Festival coordinator strives to accommodate all requests. Scheduling will be on a first-come, first-served basis, with consideration given to ensembles traveling from greater distances.

	Tuesday, February 7
	Wednesday, February 8

Will this group utilize performers, equipment, accompanists, etc. from another ensemble?
Yes No
If YES, what is the name of the other ensemble?

FOOD SERVICE REQUEST

Meal tickets for the Roberts Commons Dining Hall will be included in your packet at the Registration Desk upon check-in.

Tuesday, February 7		- OR -	Wednesday, February 8
	11:00 a.m. - 11:30 a.m.			11:00 a.m. - 11:30 a.m.
	11:30 a.m. - 12:00 p.m.			11:30 a.m. - 12:00 p.m.
	12:30 p.m. - 1:00 p.m.			12:30 p.m. - 1:00 p.m.

	Dining Hall	- OR -		Box Lunch

STAGE SET-UP REQUEST

Stage set-up Form (Instrumental)
Stage Set-up Form (Vocal)

The Stage Set-up request form is optional. The director may complete it now and attach it via this online form or mail it in.

Attach your requested Stage Set-up as an image:

- or -

Attach your requested Stage Set-up as a document:

PAYMENT INFORMATION

Quantity

Description

Unit

Amount

Registration

$90.00

Food Service

$7.00

Headliner Concert

$20.00

TOTAL AMOUNT

The School Voucher and Purchase Order options below are optional. The director may complete it now and attach it via this online form or mail it in.

	School Voucher	(attach document)
	School Purchase Order	(attach document)
	Credit Card
	Card Number:
	Expiration Date:

Reservation Deadline: Friday, December 16, 2011

Enter the code above here:

Can't read the image? Click here to refresh.