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: ______________________________________________________
________________________________________________________________________________
Class 1: ________________________________ Class 2: ________________________________
Class 3: ________________________________ Class 4: ________________________________
| _________ | Workshop Tuition $150: Full Weekend (includes both concert & ceilidh), |
| _________ | Catered Lunches ($12 each) |
| _________ | Extra Concert or Ceilidh Tickets (tickets are $15 adult, $12 senior, $8 children) |
| _________ | Amount Due |
| _________ | 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 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 by 1 month before your program, 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 two weeks prior to program 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.