2009 MassACDA Summer Conference
Fees & Registration
Name ___________________________________________________________________
Address _________________________________________________________________
City__________________________________________ State__________ Zip_________
Home phone_______________________ Work phone____________________________
Email ___________________________________________________________________
Requested roommate ______________________________________________________
(Optional; same gender roommate only)
Social Security No. ________________________________________________________
(required for all participants seeking graduate credit)
| Are you seeking professional development points (PDP's)? |
 |
Yes |
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No |
|
Are you seeking graduate credit (bachelor’s degree required)? |
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Yes |
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No |
| Workshop Fees (Participation or PDPs, checks made payable to MA ACDA) | |
|
Regular Registration _____ Noncredit registration rec'd by May 31 ($230) _____ Noncredit registration rec'd by June 15 ($250) _____ Noncredit registration rec'd after June 15 ($270) |
Special Rates _____ Student rate ($60) (Valid student ID req'd, no credit avail)
_____ Per diem = No. of days x $80 Circle
days: S M T W _____ Retiree ($170) |
|
Graduate Credit fees (in addition to workshop fee, checks for graduate credit made payable to Gordon College) _____ One (1) graduate credit ($160) _____ One (1) graduate credit ($185) if registrations for credit received after July 1 |
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Meal Plans (optional) _____ Meal Plan A: July 13–15, lunch only ($27) _____ Meal Plan B: July 13–15, all meals ($78) - --or-- Create your own (circle days requested) _____ Breakfast ( M T W ) x $7 each _____ Lunch ( M T W ) x $9 each _____ Dinner ( M T W ) x $10 each |
Housing Plans (optional) _____ Plan A1: July 12–15, single occupancy ($138) _____ Plan A2: July 12–15, double occupancy ($108) --or-- Create your own (indicate NIGHTS room requested) _____ On-campus single occupancy ( S M T ) x $46/night _____ On-campus double occupancy ( S M T ) x $36/night |
|
total = $ |
Payment Method (circle one): Cash Check (NOTE: Credit card payments not accepted.) |
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OFFICE USE ONLY |
Please return this form with payment to: |
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Date ID # Total due Worksheet
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Summer Music Education Workshop Gordon College, Dept. of Music 255 Grapevine Rd. Wenham, MA 01984 |
Requests for refunds must be made by July 1, 2009.
For more information, call 978.867.4429
Last revised April 30, 2009
