Port Townsend Early Music Workshop - 2017
Registration Form
EARLY REGISTRATION ADVISED

First Name:
Address:
City or Town:
Phone
Email
Fax
What is your primary instrument?
Please tell us your playing level (select one):
  (See "Recorder Level Guide" or "Viol Level Guide" to self-assess your playing level.)
Sizes of instruments you plan to bring (select all that apply):
Do you have any dietary
restrictions or requests?
Do you have any physical
handicaps that we should
know about?
Roommate requests:
Out-of-towners:
Seattle Recorder Society members:
Class selections will be sent electronically after your registration form and check are received.
on Saturday July 8
You may pay a $100 Deposit per person with your Registration to reserve your position in the Workshop. The deposit is $100, of which $50 is refundable until May 1, 2017. The deposit is a down payment on your total tuition. The balance of all your fees (minus the $100 deposit) is due by June 1, 2017.
PLEASE SELECT YOUR TUITION OPTION BELOW:
If paying by check or money order, please mail your a copy of your completed registration form along with your check in U.S. currency payable to “Seattle Recorder Society” to:

Port Townsend Early Music Workshop
c/o Jo Baim, Administrative Director
4727 – 42nd Ave. SW #207
Seattle, WA 98116
State/Province:
ZIP:
Recorders:
Viols:
Vocal range:
Any other instruments you will be bringing?
(include size or voice)
I will pay by (select one):
NOTE: Payment instructions and steps will appear after you complete and submit this registration form.

  • You may want to print this registration page for your records and for mailing with payment before submitting it.

  • PRESS THE "Submit" button to send this registration.
DEPOSIT
At this time I will pay:
PAYMENT

NOTE: Your registration is not valid until a deposit or full payment  is received.
= Required Fields
Others requests:
Last Name:
TUITION
Please check hospitality option below:
I can provide hospitality for (select from drop down):
on Saturday July 15
I prefer to receive future communications:
Cancel and Return to SRS website
PLEASE SUBMIT A SEPARATE REGISTRATION FOR EACH WORKSHOP PARTICIPANT
Early Reed Instruments:
(indicate size and type)
by e-mail   by hardcopy mailed to my home
lower intermediate    intermediate    upper intermediate    advanced
Sopranino
Soprano
Alto
Tenor
Bass
Great Bass
Contra Bass
Treble
Tenor
Bass
Soprano    Alto    Tenor    Bass   
I need Hospitality Saturday July 8
I need Hospitality Saturday July 15
Full Tuition (including housing & meals):     @ $1100.00
Commuter Tuition (NO housing or meals):   @ $575.00
$100 Deposit only       All Registration Fees (Tuition and any Housing/Meal fees)
Check or Money Order (I will mail).
Online (Credit/Debit Card or PayPal).