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 $35/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 Rentals ($40)


Friday Afternoon Class/Clinic ($25)


Monday Pibroch Workshop ($50/session (am or pm), $75 all day)

_________ Extra Concert Tickets(tickets are $20 adult, $18 senior, $10 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.

_________ Payment by PayPal (instructions)


If you cancel before December 15, we can refund all but your deposit. After January 1, 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.