Upper Potomac Irish Weekend
Application Form

send to: PO Box 1474, Shepherdstown, WV 25443 


Send one application per student please.

Name______________________________________________________
Address:___________________________________________________
City:_________________________State:______Zipcode_____________
Phone: (home)_________________ (cell or work)___________________
Email:_____________________________________________________
I play (instrument/s)_________________________at ___________level.

Scholarship request. 
Please submit before 9/15/08 for consideration. Contact office for information.
______I am interested in a housing scholarship in exchange for 2-3 hours of work over the weekend.

______I am interested in a tuition scholarship in exchange for a performance in a local school, hospital or nursing home. 

Class interest: Please list instrument or instructor
Morning:_______________________________________________
Afternoon:______________________________________________

Tuition and Fees:

________ Full program $110 or $90 before 9/15/08 (Includes Concert, Ceili and both workshops)

________ Saturday Only $100 or $80 before 9/15/08 (Includes Ceili)

________ Single Workshop $40 (while space lasts)

________ Set Dancer's Special $40 (Includes afternoon set dance class and evening dance)

________ Concert only $15 adults, $12 seniors, $10 SMD members, $8 children/students

________ Dance Only $15 general public, $10 SMD members or attendee family members.

________ Grand Total Enclosed

Cancellation Policy:
If you must cancel, we can refund all tuition except the $30 deposit, provided you do it before September 1.  Students canceling late due to extreme circumstances should send written documentation of their reason for canceling; these requests will be reviewed after the festival.