Workshop Registration – Bloom Early Music

First Name *

Last Name *

Badge nameThis is only if the name you want on a badge is different from your first + last names

Email Address *

Phone

Mailing Address *

City

State/Province

ZIP / Postal Code

Country

Food preferencesPlease let us know your food preference (such as vegetarian or vegan) and list any food allergies. If this field is left blank, we will assume no allergies or specific dietary requirements.

Instruments you intend to play0 / 100

General playing ability *

Viol players, what instruments do you plan to bring?

TrebleTenorBass

Singers, which vocal part(s) do you sing?

SopranoAltoTenorBass

All musicians, which clefs do you read fluently?

Treble clef"Alto up" treble clef (recorders)Alto clef (viols)Bass clef

Friday potluckIf you would like to bring a food or drink item to share as a potluck addition to Friday evening’s catered dinner, please let us know what you intend to bring.0 / 100

Do you have any questions or any information that will be helpful to us in assigning classes?

Workshop fee is $195 and includes: tuition, Big Blow and Bow booklet, Friday night dinner, Saturday light breakfast, Saturday lunch, Sunday light breakfast, coffee, tea.

Donation to Scholarship Fund

USD

Only use this if paying now with PayPal

Total amount due ($195 workshop fee + any donation amount you entered)

I would like to pay by ... *

To pay by check, make it out to "Mountain Collegium" and send it to:

Anne Stevenson Smith

Bloom Registrar

192 Albemarle Drive

Penllyn PA 19422

Be sure to include the registered participant's name and the amount of any donation.

To pay by PayPal at a later date, go to the Payments page.

Have questions? Contact Susan at director@bloomearlymusic.org or 570-441-2774.

To apply for a scholarship, fill out the Barry Moyer Workstudy application no later than July 30 and do not pay at this time.

The PayPal button will pop up a PayPal checkout window and submit your registration information after you've successfully paid. If you aren't really ready to pay now, choose one of the other options from the dropdown. You can always pay with PayPal later by going to the Payments page.

Recorder players, what instruments do you plan to bring?

Viol players, what instruments do you plan to bring?

Singers, which vocal part(s) do you sing?

All musicians, which clefs do you read fluently?