The Synthesis Midi Workshop - a resource for music educators and theological institutions

Instructions:

FIRST, complete the following Registration Form by typing in the appropriate information. THEN, print out the form and sign it (if you are paying by credit card). Optional college credit or clock hours will be made available thru Seattle Pacific University on the first day of class.

Mail along with your payment or school PO to:
The Synthesis Midi Workshop
PO Box 1277
Carson, WA 98610

Upon receipt of this registration you will receive back detailed confirmation and receipt of your payment.

Date: _________________________

First Name: _______________________ Last: ________________________

Street Address: __________________________________________________

City: __________________ State: ________ Zip: _________________

Telephone (home): __________________

email __________________________________________

Payment Method (check one only):

Check payable to The Synthesis Midi Workshop
School PO payable to The Synthesis Midi Workshop
Charge to credit card : Visa MC Amex Discover (circle one)
Card #: _____________________________ Exp: ________________
We do not charge your card until the first day of class. You may cancel your registration and receive a full refund or credit within 14 days prior to the workshop starting date. Failure to do so within the 14 day grace period will result in a $50 cancellation fee. In the event of a cancellation due to weather, any other "act of God" ,or due to low enrollment, you will receive a full refund or credit.
Credit Card Orders: Enter your address as it appears on your credit card monthly statement:

_________________________________________

_________________________________________

__________________________________________

Your Signature:____________________________________________________

SPU Credit No credit

Course Name: ________________________________________ Dates: _______________