North Shore Summer Music Experience: Registration Form

Print this page and complete all areas

Name:

Address:

City/State/Zip:

Date of Birth:

Daytime Phone (include area code):

Parent/Guardian Name:

Parent/Guardian Daytime Phone (include area code):

School Name:

School Grade (Fall '06)

Sex: M____ F____

I will stay on campus ____ or I will commute ____

T-shirt size: M____ L ____ XL____ XXL____

Choose One:

____ Band/Jazz

Instrument:

for how long?

____ Choral

soprano:

alto:

tenor:

bass:

how long?

____ Strings

Instrument:

for how long?

Payment Options

____ $75 deposit enclosed (full payment due by June 13, 2008)
____ Total Enclosed	$439 ____ Resident (Stay on Campus) $255 ____ Non-resident (Commuter)

Checks are to be made payable to the University of Minnesota Duluth.