Jazz Hands For Autism

10220 Culver Blvd, Ste 101, Culver City, CA 90232

Student Application - JHJobs

ABOUT YOU


check all that apply

Choices based on 2020 U.S. Census. Check all that apply. Specify more details on.

Add notes/Explain if need be

what do you want to be called?

How do you want to be called as an Artist?

Please include all diagnoses including behavioral, developmental and medical put N/A if not applicable

(mobility arrangements, one-on-one staff, nonverbal, etc. If none, please enter N/A)

Do you use the bus? Access? Get rides from mom/dad/ family? Do you travel on your own?

put N/A if not applicable

put N/A if not applicable

put N/A if not applicable

put N/A if not applicable

put N/A if not applicable

put N/A if not applicable

put N/A if not applicable

put N/A if not applicable

ABOUT YOUR MUSIC & CAREER


What is the top instrument do you want to learn or be better at?

Check all that apply. Any additional instruments that you'd like to learn?

Describe any musical experience you had in the past. mention instruments if applicable (#years playing, how was trained with instrument, self taught/1on1 lessons). Mention any music production software you have experience in if applicable

answer with the best of your ability. There is no right or wrong answer.

What are your long term goals? What do you want to be in 3 years from now? 5 years? 10 years? If you don't know it, put I don't know

what do you want to learn, what are your goals by the end of this program, what do you need help on, etc.

What other talents or skills do you have aside from music? (acting, drawing, animation, etc)

document with student's current goals

pdf format

pdf format

pdf format

Tell us what type of internet connection you have

Anything else you'd like JHFA to know

YOUR SUPPORT SYSTEM

FUNDING INFORMATION


Select N/A if Not Applicable

SIGNATURE

Required