Upper Potomac Music Weekends
Piper's Weekend Application Form

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

 

Name: __________________________________________________________________________

Address: ________________________________________________________________________

City: _______________________________________ State: ______________ Zip: _____________

Phone (home): _____________________________ (work): ________________________________

E-mail: __________________________________________________________________________

I play these instruments: ____________________________________________________________

Playing Level: _____________________________________________________________________

Class Choice: List teacher preference for each time slot


Class 1: __________________________________________________________________________

Class 2: __________________________________________________________________________

Class 3: __________________________________________________________________________

Class 4: __________________________________________________________________________

Lesson Requested with: _____________________________________________________________
     Pay $30/half hour (cash preferred) at lesson, directly to instructor.

 

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

Tuition and Fees

_________

Full 2 Day Workshop Session ($195)

($160 if paid in FULL by Dec. 1) or
Non-refundable Deposit $35 (holds your space until Dec 20)

_________

Tuition for Saturday Only ($120)

($100 if paid in FULL by Dec. 1)
_________

Tuition for Sunday Only ($95)

($75 if paid in FULL by Dec. 1)
_________

Single Group Class ($50)

_________

Weekend Pipe or Uke Rentals ($40)

_________ Extra Concert Tickets(tickets are $18 adult, $15 senior, $8 student)
_________ Catered Lunches ($15 each)( Sat ___ )
_________

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 UPPW, and mail to address above.

  OR
_________ Payment by PayPal (instructions)

Cancellations:

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

Students canceling after December 15 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.