Please register me for the following:

[There are no workshops or classes scheduled at this time]

Name

Address

City , State Select a State ---------------- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming British Columbia Zip

Phone (day)   (eve)

Fax

E-mail address

Singer        voice type:

Voice range:

Instrumentalist: 

Other instruments I will bring:

I would like information about accommodations during the workshop.

 Please consider me for a partial scholarship.

NWCEMS maintains an active scholarship program.  Scholarships are awarded on a basis of financial need, independent of age, ability level, or musical specialty.   Anyone for whom workshop fees are a financial hardship is encouraged to request partial scholarship assistance.

Payment

$150 US for registration by Dec. 20, 2005, $175 after that date.

To register, send $50 deposit with this registration form. Registration deposit is not refundable.  Balance of fee is due at beginning of the workshop.

Total Payment Enclosed: $

Please charge my MasterCard.

Please charge my VISA.

Card #: Exp. date:

Class and workshop deposits are refundable until the stated registration deadline. Any pre-paid fees over registration deposits are refundable until the class or workshop begins; fees are not refundable once a class starts. In case of cancellation of a class or workshop, all deposits and pre-paid fees will be refunded.

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