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).

Cancellations:

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.