2022 Chaparral Chamber Music Workshop Registration

2022 Chaparral Chamber Music Workshop
Online Registration

Estimated registration completion time is 5 minutes. No option to save partially completed registration form.
Participant Information
Registration Feb 15 to Mar 15, 2022.
- Early registration is encouraged to guarantee your spot.
- Late registration possible pending space availability. Group assignments take place April 1-20.
You are encouraged to pay online through this form using a credit or debit card.
- You DO NOT NEED a PayPal account to pay your registration fee online.
- If you do not have a Paypal account, sign in as a "guest".
- If you need to pay by check, after submitting this form, mail your check to: Debbie O'Brien 952 West Plata Ave Mesa, AZ 85210
Please submit a separate form for each participant.
- Only one student may be registered at a time.
- When you are done filling out the form, scroll to the bottom and click " SUBMIT FORM AND PAY" button.
- If your registration was successful you will get an email confirmation.
Participant's Full Name *

First Name Last Name
Participant Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
E-mail Address where you'd like to receive confirmation and information: *
example@example.com
Phone Number: *

Area Code Phone Number
If under 18, Parent/Guardian Phone Number:

Area Code Phone Number
Food allergies
Any comments or clarifications you wish to add including musicians you'd like to play with and/or repertoire you'd like to play. If you are coming with a pre-formed group, please list names/instruments of the group members and tell us if you are coming with repertoire to work on. Whichever option you choose, we will contact you to confirm all details. Thank you!
Track, Instrument and Level
The primary instrument you will be playing: *
I am registering for (Choose One): *

Youth Track (entering 7th-12th Grade, in Fall 2022) Adult Track (18-up, includes adult learners)
(Optional) 2nd instrument you'd like to play:
Playing level on the primary instrument listed above; for description click on link below. *

Novice, includes adult learners Intermediate Advanced Expert Professional
https://tinyurl.com/y29vpjxr
(Optional) Playing level on the secondary instrument listed above; for description click on link above.

Novice, includes adult learners Intermediate Advanced Expert Professional
Photo/Video Release
By registering you give Chaparral Chamber Music Workshop permission to use participant's photo in marketing materials and on the website. Check box below to opt out.

Opt out
Payment
Course Fees:

Full payment of all fees (in U.S. Currency) must be received in order for the registration to be processed.

The course fee is $215.00 which includes a non-refundable $25.00 registration fee.

To Pay Course Fee in Full:

You are encouraged to pay online through this form. YOU DO NOT need to have a PayPal account to use this system and may use credit card or debit card. If you do not have a Paypal account, sign in as a "guest".

To Apply for a Scholarship:

To apply for any Adult or Youth Scholarship, complete the registration and answer the questions under Scholarship Request, below.

Adults and non-Prescott Youth- A limited number of need-based scholarships are offered for youth and adults. You must register for the workshop and indicate your request for a scholarship no later than April 25. You are encouraged to make your request early. If you are seeking a scholarship, please fill out the information below.

Prescott Youth only- automatic JS Acker Scholarships are available to those 17 and under with a Prescott mailing address. This scholarship covers half or full tuition less the $25 registration fee. Please apply and the Director will contact you. Choose this option ONLY if your mailing address lists Prescott, AZ as the city and state.

If you need to pay by check, please

• make your check out to Chaparral Chamber Music Workshop
• write the participant's name in the Memo field
• and mail it to:

Chaparral Chamber Music Workshop
c/o Debbie O'Brien 952 West Plata Ave Mesa, AZ 85210

Chaparral Chamber Music Workshop reserves the right to cancel and refund fees due to insufficient enrollment. A $35 service fee will be charged for all returned checks.
Current Date: *

Month Day Year
REGISTRATION & FEE PAYMENT: (1) Click on 1 of the 4 choices below (2) If applicable, fill out the scholarship request (3) Click "Submit Form and Pay" button at the end of the form OR YOUR REGISTRATION WILL NOT BE RECEIVED. *
prev next ( X )
I am paying the normal Chaparral Chamber Music Workshop Fee $ 215.00

I am paying the $25 CCMW registration fee only. I am applying for a scholarship and will pay the balance upon notification of my scholarship amount. $ 25.00

I am paying by check and will mail it in. Free

I have applied and been accepted as an intern and am paying the $25 registration fee. $ 25.00
Prescott Youth only:

Yes, please offer me a JS Acker Scholarship.
Adult and non-Prescott Youth:

Yes, please offer me a need-based scholarship.
I qualify for a scholarship because:

I qualify for government assistance. I have other qualifications for a need-based scholarship (Please elaborate below).
The amount I feel I can afford is:
Your responses are completely confidential.
Final Step and Payment
After completing the registration form, all applicants including those requesting scholarship, click the orange button, "Submit Form and Pay" at the bottom of this page.

"Submit Form and Pay" button will automatically direct you to PayPal.
- At this point, those paying online will pay by credit or debit card.
- If you are paying by check, you are done with the registration form. You may print out your form, close your browser and mail your check.
Registration is NOT complete until payment is received.

If your registration was successful, you will receive an email confirmation.

For help with online registration, email Debbie O'Brien at register@chaparralchambermusic.org

We look forward to making music with you in Prescott!
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2022 Chaparral Chamber Music Workshop

Online Registration

Participant Information

Track, Instrument and Level

Photo/Video Release

Payment

Final Step and Payment