Jorma Kaukonen's Fur Peace Ranch Guitar Camp 201 8 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

Jan 29 Feb 02, 2018 Sundial Beach Resort Jorma Kaukonen Feb 05 09, 2018 Sanibel, FL Jorma Kaukonen w/ David Wolff

Mar 2326, 2018 Fur Peace Ranch, Double Dose Acoustic Weekend *Specialty Weekend* Pomeroy, OH Jorma Kaukonen, Jack Casady

Fur Peace Ranch, Apr 1316 2018 Jorma Kaukonen, Larry Campbell, Pomeroy, OH Spencer Bohren

Fur Peace Ranch, Jorma Kaukonen, Spencer Bohren, Apr 2023, 2018 Pomeroy, OH David Wilcox

Fur Peace Ranch, Jorma Kaukonen w/ Tom Feldmann, May 1114, 2018 Pomeroy, OH Happy Traum, Woody Mann

Fur Peace Ranch, Jorma Kaukonen, G.E. Smith, Pat May 1821, 2018 Pomeroy, OH Donohue

Fur Peace Ranch, June 1518, 2018 Entrance Ramp w/ Jorma Kaukonen, Pomeroy, OH Tom Feldmann & David Wolff

Aug 1013, 2018 Fur Peace Ranch, Jorma Kaukonen, Dave Revels, Bob Couples' Weekend Pomeroy, OH Margolin

Aug 1720 Fur Peace Ranch, Spencer Bohren, Bryan Sutton, Toby Pomeroy, OH Walker

Fur Peace Ranch, Jorma Kaukonen w/ Tom Feldmann, Sep 2124, 2018 Pomeroy, OH Pete Sears, Barry Sless

Sep 28 Oct 1, 2018 Fur Peace Ranch, Bill Kirchen, Gretchen Peters, Geoff PickNPutt Pomeroy, OH Achison

Oct 1922, 2018 Fur Peace Ranch, Jorma Kaukonen w/ Tom Feldmann, Rev. Gary Davis Pomeroy, OH Larry Campbell, Roy Book Binder

Jorma Kaukonen, Al Petteway, October 2629, 2018 Fur Peace Ranch, Pomeroy, OH Steve James (Mandolin)

Nov 0912, 2018 Fur Peace Ranch, Jorma Kaukonen w/ Tom Feldmann, *Specialty Weekend* Pomeroy, OH Jack Casady Nov 1619, 2018 Fur Peace Ranch, Double Dose Electric Weekend *Specialty Weekend* Pomeroy, OH Jorma Kaukonen, Jack Casady

Dates are subject to change. See website for schedule changes: www.furpeaceranch.com © 2017 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?

© 2017 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: $1550 Special Weekend (March 1720) $1700 $ 75 Acoustic Guitar Rental OTR @ Sundial Beach Resort : $2599 OTR @ Sundial Beach Resort (no lodging): $2099 $275 Guest fee (lodging off site) $400 Guest fee with cabin lodging with Other Charges enrolled student (space permiting) +$ $450 Guest fee for On The Road session at the Sundial Beach Resort & Spa Sub Total =$

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.