Bursary application

If you are a teacher and wish to recommend a student for a bursary place please complete the form below:

Tutor's Name (required)

Tutor Email (required)

Name of Student

Age of Student

Student's parent or guardian email


Emergency Contact

Contact 1 name:

Contact 1 number:

Contact 1 relationship:

Contact 2 name:

Contact 2 number:

Contact 2 relationship:

Student instrument

Student Grade

Student School

Please tell us how would you would rate this student in terms of chord knowledge:

Please tell us how would you would rate this student in terms of live playing:

Select the option that best describes this student's reading level

Select the option that best describes this student's improvisation level

Please tell us a little about why your student should receive an award from The spike Robinson foundation:

Any medical or learning conditions we should be made aware of:

I give consent for photo’s taken during the course to be used by “jazz Warriors" for future promotion and advertising. Y/N (must tick one of the two to complete the form.
YesNo