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Placement Form for Rock Band, Blues Band, and Jazz Combo

Student Name:*
Age:*
Parent/Guardian Name:*
Program:*

Rock Band


At Levine, students experience what it's like to work together in a professional-style rock band in this 8-week rock n' roll experience. Whether you play guitar, bass, drums, keyboards, or sing, we pair you with other like-minded musicians around the same age and ability.

What is your primary instrument?*
What other instrument(s) can you play (even a little)?*

Please list any instrument you could play in the band, including violin, sax, mandolin, harmonica, etc.

What other instrument(s) would you be interested in trying?*
Do you have any previous band experience?*
Have you ever taken private lessons on your primary instrument?*
Do you currently take private lessons on your primary instrument?*

On a scale of 1 to 5, where 1 is "not at all comfortable" and 5 is "very comfortable," please indicate your comfort level with the following skills:

Please identify your current skills by selecting one of the following:

Recording for Rock Band

What is your primary instrument?*
What other instrument(s) can you play (even a little)?*

Please list any instrument you could play in the band, including violin, sax, mandolin, harmonica, etc.

What other instrument(s) would you be interested in trying?*
Do you have any previous band experience?*
Have you ever taken private lessons on your primary instrument?*
Do you currently take private lessons on your primary instrument?*

On a scale of 1 to 5, where 1 is "not at all comfortable" and 5 is "very comfortable," please indicate your comfort level with the following skills:

Please identify your current skills by selecting one of the following:

Blues Band


At Levine, students experience what it's like to work together in a professional-style blues band in this 8-week musical experience. Whether you play guitar, bass, drums, keyboards, or sing, we pair you with other like-minded musicians around the same age and ability.

What is your primary instrument?*
What other instrument(s) can you play (even a little)?*

Please list any instrument you could play in the band, including violin, sax, mandolin, harmonica, etc.

What other instrument(s) would you be interested in trying?*
Do you have any previous band experience?*
Have you ever taken private lessons on your primary instrument?*
Do you currently take private lessons on your primary instrument?*

On a scale of 1 to 5, where 1 is "not at all comfortable" and 5 is "very comfortable," please indicate your comfort level with the following skills:

Please identify your current skills by selecting one of the following:

Scheduling

Which Levine campus(es) are you interested in attending when classes meet in-person? (Select all that apply).*
Which day(s) of the week do you prefer? (Select all that apply).*
Please list the earliest and latest times you are available to attend.
Please list the earliest and latest times you are available to attend.
Please list the earliest and latest times you are available to attend.
Please list the earliest and latest times you are available to attend.
Please list the earliest and latest times you are available to attend.
Please list the earliest and latest times you are available to attend.

Jazz Combo


These small ensembles provide the opportunity for youth and adult students of all levels and instruments to deepen their knowledge of jazz and develop their skills. Students play and study standard jazz repertoire, develop their improvisation abilities, learn to work as a group, and perform in recitals and other events.

Do you currently take private lessons on yoru primary instrument?*
Have you ever played in a jazz combo before?*

On a scale of 1 to 5, where 1 is "not at all comfortable" and 5 is "very comfortable," please indicate your comfort level with the following skills:

Are you interested in talking with someone about taking private lessons at Levine?

Jazz Combo Scheduling

Which Levine campus(es) are you interested in attending when classes meet in-person? (Select all that apply).*
Which day(s) of the week do you prefer? (Select all that apply)*
Please list the earliest and latest times you are available to attend.
Please list the earliest and latest times you are available to attend.
Please list the earliest and latest times you are available to attend.
Please list the earliest and latest times you are available to attend.
Please list the earliest and latest times you are available to attend.
Please list the earliest and latest times you are available to attend.
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