REGISTRATION FORM

THE UNIVERSITY OF MIAMI’S
20th ANNUAL SUMMER
TEACHER WORKSHOP
for
"GUITAR, BASS-GUITAR, & DRUMSET"
June 14 - June 18, 2010
In Conjunction with the "Guitar, Bass-Guitar, & Drumset Camp"
Please Type or Print Clearly
Please Use One Form per Teacher

NAME: _________________________________________________

ADDRESS:_________________________________________________

(City) (State) (Zip)___________________________________________

SCHOOL NAME:____________________________________________

WORK PHONE: ( ___)__________________

FAX:( _____)_________________________

HOME PHONE: (______)______________________

CELL PHONE: (_______)_____________________

EMAIL ADDRESS: (_______)_____________________

INSTRUMENT: GUITAR _____ BASS-GUITAR ______

DRUMS___________

YEARS OF STUDY: In School ____Private Teachers ____

Your Primary Instrument(s)____________________

FEES: (Check Appropriate Space) Includes all Instructional Materials, Lunch and T-Shirt

CHECK ONE:
T-SHIRT SIZE: (MEN'S) ____SMALL ____MEDIUM ___LARGE ____ X-LARGE
ADDITIONAL $4.00 FOR THESE SIZES: 1X ____ 2X ____ 3X _____ 4X ____

Circle Appropriate Workshop:

TEACHER WORKSHOP: 9am to 5pm (AUDIT FEE)........$295
(Full Time Teachers receive a 10% Discount off auditing fee)             

TEACHER WORKSHOP: CREDITS Through the University of Miami Music School
 Please call (305) 284-5813 for details on obtaining credits.
Available: 3 Credits Grad or Undergrad.


Dormitory/Housing: ($25 per night @ 6 nights).....$150 

Registration Fee (For all Teachers) $ 25

----------------------------------------------------------------------------------

Check or Money Order Should be Made Payable To:
UNIVERSITY OF MIAMI

(The Rest of the Payment Must be Received by June 10, 2010 to Secure
Your Spot)

To Charge Workshop Fees to VISA or MASTERCARD, Complete the Following:

VISA or MASTERCARD (Circle One)

Expiration Date: ________________________________

Name on Card: _________________________________

Card Number: __________________________________

Signature: ______________________________________

Amount to Charge: $ _____________________

_______Non-Refundable $25 deposit enclosed

PLEASE PRINT OUT THIS FORM, FILL IT OUT AND MAIL TO:

DR. RENE GONZALEZ, DIRECTOR
GUITAR CAMP
UNIVERSITY OF MIAMI
P.O. BOX 248165
CORAL GABLES, FL 33124

OR FAX FORM TO:
FAX: (305) 858-0535

PHONE: (305) 858-8189 (EFM)
or
(305) 284-2083 (Dr. Gonzalez)