Upper Potomac Music Weekends
Spring Music Weekend Application Form

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


Name: __________________________________________________________________________

Address: ________________________________________________________________________

City: _______________________________________ State: ______________ Zip: _____________

Phone (home): _____________________________ (cell): ________________________________

E-mail: __________________________________________________________________________

I play these instruments: ____________________________________________________________

Playing Level: _____________________________________________________________________

Class Choices: (Please list instructor's name)


Friday ____________________ Saturday ____________________ Sunday ____________________

(Classes may be dropped if there is not sufficient interest by February 15, 2017)

Tuition and Fees

_________ Weekend Workshop Sessions ($195)(includes concert and all evening events)
($170 Early Bird Tuition Rate until February 15th)
(Friday Class is $50 additional for weekend registrants)
_________ Single Day Workshop
___ Friday $85 ($75 if paid by February 15th)
___ Saturday $95 ($85 if paid by February 15th)
___ Sunday $80 ($70 if paid by February 15th)
_________ Saturday Catered Lunch ($15)
_________ Extra Friday Concert Tickets(tickets are $20 adult, $18 senior, $10 children)
  Rental Instrument for 3 days
( ___$30 for 12/11, ____$40 for a larger chromatic instrument)
_________ Amount Due March 1

Optional Donation to the UPDF Scholarship Fund

UPDF is a tax-exempt charitable organization.

Please help us continue our scholarship program!


Grand Total Enclosed

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

_________ Payment by PayPal (instructions)

All Classes are filled on a first-come first-served basis.
Checks may be made out to UPDF.


If you cancel by February 15, we can refund half of your deposit. If you cancel later we will keep the entire deposit. Phone cancellations must be followed by written notice of cancellation. Students canceling after March 1 due to unavoidable circumstances may send written documentation of their reason for canceling and request a partial tuition refund. These refund requests will be considered by our board following the end of the program.