:: DIU Jazz Ensemble Registration Form


To register over the phone by credit card simply call 516-826-7776 and speak with John Riolo. Give him your registration information and credit card details. You can also simply mail in your check. See the bottom of this page for check mailing details.


Registration Form
Fall Semester
September 10th, 2008 - May 13th, 2009

* Students must register no later than September 1st, 2008



Name _____________________________________________________




Street Address______________________________________________




City, State, Zip______________________________________________




Instrument_________________________________________________




Email Address_______________________________________________




Phone#____________________________________________________




Once accepted into the Jazz Ensemble, please print out this form, complete it and

mail the form with a check for $280 payable to:


Do It Up Performing Arts Center
2221 Jerusalem Ave.
N. Merrick, NY 11566