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I would like to receive/continue to receive JAZZed FREE of Charge:
Yes No
1.) What is your primary educational institution/business: (Check one):
(01) Senior High
(02) Independent teacher
(03) College/University
(04) Manufacturer of musical instruments
(05) Retailer/dealer of musical instruments
(06) Music Publisher
(07) Other (Please Specify):
2.) What is your position? (Check one):
(11) Jazz director
(12) Band director
(13) Orchestra director
(14) Choir director
(15) Assistant director
(16) Music teacher/instructor
(17) Owner/executive
(20) Other (Please Specify):
3). What type of ensembles are you responsible for: (check all that apply)
(BB) Big band
(SE) Small ensemble
(JO) Jass orchestra
(NA) None
(ZZ) Other (Please Specify):
4). What is the total enrollment of your school:
(A) 0 - 500
(B) 501 - 1000
(C) 1001 - 2000
(D) Over 2000
(X) Not a school
5). Are you a:
(E) Public school
(F) Private school
(G) Private teacher
(X) Not a school
6). Total number of music students:
n order to verify your request for this publication, without the availability of a signature our audit bureau requires that we ask a personal identifying question. This information is used solely for the purpose of auditing your request.
What is the last digit of the year you were born? | 
