Upper Potomac Music Weekends
Pipers Weekend Application Form

Send one form per person please!
Mail to: UPMW, PO Box 1474, Shepherdstown, WV 25443


Name: __________________________________________________________________________

Address: ________________________________________________________________________

City: _______________________________________ State: ______________ Zip: _____________

Phone (home): _____________________________ (work): ________________________________

E-mail: __________________________________________________________________________

I play these instruments / level: ______________________________________________________


Classes Selected: List teacher preference for each time slot

Class 1: ________________________________     Class 2: ________________________________

Class 3: ________________________________     Class 4: ________________________________

*Classes will be filled on a first-come, first-served basis

Tuition and Fees


Full 2 Day Workshop Session ($140)

($125 if paid in FULL by Dec. 1) or
Non-refundable Deposit $25 (holds your space until Jan 1)


Tuition for Saturday only ($100)

($90 if paid in FULL by Dec. 1)


Tuition for Sunday only ($75)

($65 if paid in FULL by Dec. 1)

_________ Single Group class ($40)

Extra Concert tickets

($15 adult, $12 senior, $8 student)

_________ Saturday Lunch ($12)

Optional Donation to the UPDF Scholarship Fund

UPDF is a tax-exempt charitable organization.

Please help us continue our scholarship program!


Grand Total Enclosed or _____ Invoice by PayPal

Make checks payabe to UPMW, and mail to address above.

Tuition Deposit: We can hold your spot until one month before the weekend with a deposit of $50 (non-refundable).


If you cancel before December 10, we can refund all but your deposit. After December 15, we keep the entire tuition.

Students canceling after December 20 due to unavoidable circumstances may send written documentation of their reason for canceling and request a partial refund. Phone cancellations must be followed by written notice of cancellation. These requests will be considered following the end of the program.

If our entire program is cancelled due to extreme weather conditions, your entire tuition will be refunded. If we run a program, there will be no refunds available.