Jorma Kaukonen's Fur Peace Ranch Guitar Camp 201 9 Student Workshop Application

The Fur Peace Ranch has the right to refuse any application or student, but does not discriminate based on sex, race, or religion. Student/Instructor ratio is approximately 10:1, or less; therefore, spaces are limited and reserved on a first come, first serve basis. Workshop spaces can only be held with a deposit and a signed application. (See tuition information for application requirements). All fields should be completed to the best of your knowledge unless not specifically applicable. Gift Certificates: If you are purchasing a gift certificate please fill out sctions A, D, E & F only. Mail to: Fur Peace Ranch, 39495 St. Clair Rd., Pomeroy, OH 45769 or fax to 7409929126. By signing the application you are entering into a legally binding contract with Fur Peace Ranch, Inc. and acknowledging that you have read and understand all the rules, regulations and cancellation policies of the Fur Peace Ranch, Inc.

Name Tel # Address Cell # City State Zip Country Code Email Birthdate Gender Cabin/Offsite

Name of Parent or Guardian (if under 18) Tel # Business Address Tel # Occupation Emergency Contact #1 Tel # Emergency Contact #2 Tel #

Allergies Yes No Explanation/Medicines

Dietary (please choose one): Vegetarian: ____Vegan: ____ Gluten Free: ____ No Restrictions: ____

Any other medical conditions of which our staff should be aware

You may enroll in multiple workshops using this form. Please circle each workshop session and instructor below. C

Sundial Beach Resort Enrollment Jan 28 Feb 1, 2019 Jorma Kaukonen Songwriting Sanibel, FL Opens 7/1

Sundial Beach Resort Enrollment Feb 04 08, 2019 Jorma Kaukonen Master Guitar Sanibel, FL Opens 7/1

Fur Peace Ranch, Double Dose Weekend Enrollment Mar 22 25, 2019 Pomeroy, OH Jorma Kaukonen, Jack Casady Opens 7/1

Fur Peace Ranch, Enrollment Apr 12 15, 2019 Jorma Kaukonen, Larry Campbell Pomeroy, OH Opens 7/1

Fur Peace Ranch, Enrollment Jorma Kaukonen, G.E. Smith April 26 29, 2019 Pomeroy, OH Opens 7/1

Fur Peace Ranch, Enrollment May 03 06, 2019 Jorma Kaukonen, Spencer Bohren Pomeroy, OH Opens 7/1

Fur Peace Ranch, Enrollment May 17 20, 2019 Jorma Kaukonen, Woody Mann Pomeroy, OH Opens 7/1 Enrollment June 21 24, 2019 Fur Peace Ranch, Jorma Kaukonen, Tom Feldmann, Opens 7/1 Entrance Ramp Pomeroy, OH David Wolff

Aug 09 12, 2019 Fur Peace Ranch, Enrollment Jorma Kaukonen, TBA, TBA Couple's Weekend Pomeroy, OH Opens 9/1

Fur Peace Ranch, Enrollment Aug 23 26, 2019 TBA, TBA Pomeroy, OH Opens 9/1

Fur Peace Ranch, Enrollment Sep 06 09, 2019 Jorma Kaukonen, Chris Smither Pomeroy, OH Opens 9/1

Fur Peace Ranch, Enrollment Sep 20 23, 2019 Jorma Kaukonen, TBA, TBA Pick n Putt Pomeroy, OH Opens 9/1

Fur Peace Ranch, Enrollment October 18 21, 2019 Jorma Kaukonen, TBA Pomeroy, OH Opens 9/1 Enrollment Fur Peace Ranch, Electric Weekend Nov 01 4, 2019 Opens 9/1 Pomeroy, OH Jorma Kaukonen, Jack Casady Fur Peace Ranch, Double Dose Weekend Enrollment Nov 8 11, 2019 Pomeroy, OH Jorma Kaukonen, Jack Casady Opens 9/1

Dates are subject to change. See website for schedule changes: www.furpeaceranch.com © 2018 Fur Peace Ranch Inc., All Rights Reserved Skills / Goals Information Please answer questions for your particular instrument. D

Please describe your background on your instrument? (How long and in what contexts, i.e. hobby, solo, with friends, open stage, professionally?)

Please list some of the songs that you currently play?

In what style do you play them? (fingerstyle, strumming, flatpick, combo)? Are you comfortable with some pattern picking (eg Travisstyle)? BASS: Do you use a pick or fingers to play the strings?

For fingerstyle: please characterize your ability to play a steady alternating bass line (thumb) against an independent melody line. BASS: Do you understand the chordal and melodic construction of the songs or tunes you now play?

Are you aware of, or utilize chord shapes and partial shapes "up the neck", or other than first position? BASS: How comfortable are you with a walking bass line?

What do you feel are your areas of confidence and weakness?

What songs/music do you enjoy listening to and would love to be able to play?

What are your goals in taking this class? What would you like to work on?

Have you had any formal training, or attended other clinics or workshops? Do you play other instruments, e.g. guitar, piano, bass etc? Do you read chord charts, tab, or standard notation?

Have you composed originals? Is this an area you would like to explore?

© 2018 Fur Peace Ranch Inc., All Rights Reserved Payment Options A $350.00 deposit must accompany application. Make checks payable to Fur Peace Ranch, Inc. and mail to 39495 St. Clair Rd., Pomeroy, OH 45769. For additional information contact the Director's office at 7409922575 or fax to 740 E 9929126.

Workshop Tuition: Other Charges Regular Weekend: $1700 Couples Weekend: $1700 $ 75 Acoustic Guitar Rental OTR @ Sundial Beach Resort : $2599 OTR @ Sundial Beach Resort (no lodging): $2099 $300 Guest fee (lodging off site) $475 Guest fee with cabin lodging with Other Charges enrolled student (space permiting) +$ $525 Guest fee for On The Road session at the Sundial Beach Resort & Spa Sub Total =$ $1400 Workshop Fee for Spouse/Partner during Couples Weekend Total Tuition $

Deposits $350.00

Total Due $

Check Enclosed Mastercard Visa AMEX Disc. Gift Cert.

Card #: Exp Date:

Name on Card: Signature:

Signature for credit card only, all students sign below.

Applicant (Student) Signature Date:

Signature: I have read and understand the tuition guidelines, and by signing the application I understand I am entering into a legally binding contract with Fur Peace Ranch, Inc. and acknowledge that I have read and understand all of the rules, regulations and cancellation policies of the Fur Peace Ranch, Inc. Cancellation Policy: The $350.00 deposit is nonrefundable. Notification of cancellation must be given in writing (email is okay) and received no later than 4PM ET of the Final Billing Date indicated on your Account Statement (60 days prior to workshop).We will refund all monies paid (less the deposit) only if 60 days or more notice is given. After the Final Billing is processed no refunds will be given. Please see tuition policy on our website: www.furpeaceranch.com

Check here if you would like your name added to our student carpool list. List is available upon request.