SECURE REGISTRATION AND HOUSING FORM
for SPRING AUGUSTA WEEK

April 18 - 23, 2010

Tuition - $420

 
NOTE:  If you prefer to pay by check, fill out this form (DON'T click the "Submit Registration" button at the bottom);  print a copy of it; and mail it with your payment to Augusta Heritage Center, Davis & Elkins College, 100 Campus Drive, Elkins, WV 26241. If you have any questions, please call 304-637-1209 or 1-800-624-3157 ext. 1209, or you may email us at augusta@augustaheritage.com.
   

(* required information)

  
First Name:*
Name for badge:*
Last Name:*
Sex:* Male Female
Date of Birth:*     (mm-dd-yyyy)
Address:*
City and State:*
Zip:*
Country (if not US):
Home Phone:*
Day Phone (if different from home):*
Cell Phone:
Email Address:*
Fax:
 

* I have read and accept Augusta's cancellation and refund policy.  If user does not agree to the charges, cancellations, and refund policies of the Augusta Heritage Center you may terminate this transaction at this time and leave the registration page.

SPRING DULCIMER WEEK CLASS DESIRED: (select one)*

Autoharp
Novice to Beginning with John Hollandsworth 

Guitar
Novice to Beginning with John Rossbach

Hammered Dulcimer
 Beginning with Jody Marshall
 Intermediate with Christie Burns
Advanced with Sam Rizzetta

 Mountain Dulcimer
 Beginning with Molly McCormack
Intermediate with Janita Baker
Advanced with Rob Brereton

OPTIONAL EVENING MINI-COURSES
All Mini-courses meet Monday–Thursday from 6:30 to 7:45pm, unless otherwise noted.

Tuition: $45

Clogging from Scratch (novice) with Matthew Kupstas 

Fiddle from Scratch (novice) with Gerry Milnes

Mandolin from Scratch (novice) with Jeremy Wanless

 

HOUSING REQUEST

The Graceland Conference Center offers motel-type accommodations on campus for Spring Dulcimer Week. Each room has its own bath. There are three choices:

  • Single-occupancy rooms (if available) feature one queen bed for $455 plus 12% tax

  • Double-occupancy room with TWO queen beds for $245 per person plus 12% tax

  • Double-occupancy room with ONE queen bed for $227.50 per person plus 12% tax

Prices for Graceland Inn are somewhat higher. Please call 1-800-624-3157 ext.1600 or 304-637-1600 to book your own reservations at the Inn.

Pay ONLY a $25 non-refundable processing fee to reserve a room. The balance is due upon arrival. Prices are for six (6) nights.

Meals are not included in the room rate and may be purchased at check-in ($100 for 12 meals, $135 for 17 meals). Meals may also be purchased individually at the door. Click HERE for cash-at-the-door meal prices.

Please reserve housing:
 Conference Center - Double Occupancy with TWO (2) queen beds
 Conference Center - Double Occupancy with ONE (1) queen bed
 Conference Center - Single Occupancy  with ONE (1) queen bed (if available)

Please pair me with this roommate:

Please pair me with a roommate who:

Smokes                Does NOT smoke   No Preference

Is an Early Riser Is a Night Owl          No Preference

Health Problems or Special Requests :


 In case of emergency please contact:
Name:
Home Phone:
Daytime or Cell Phone:

Please enter amounts being paid in the boxes below:
(Tuition is  $420. Optional evening mini-course tuition is $45.)

TUITION

$

  HOUSING Reservation

$ Please send a $25 non-refundable housing reservation fee at this time - the rest is due on arrival (do  NOT send more at this time).
Tax-Deductible Contribution (optional)

Which fund should receive your  contribution?
    

$


(PLEASE NOTE:  For tax purposes, your contribution will be processed as a SEPARATE charge on your credit card.)
 
*TOTAL PAYMENT

$   I authorize payment of this amount on my credit card


 


If you are submitting your registration online,  PLEASE BE SURE TO COMPLETE THE FOLLOWING SECTION:

*Credit Card: 
*Credit Card Number (nnnn-nnnn-nnnn-nnnn):    -   -   -  
*V-code:     (What is a V-code, and where do I find it?)
 *Expiration Date: 
*Name as it appears on Card: 
*Credit Card billing address: