BAR HARBOR

SMJ WORKSHOP - BAR HARBOR 2022

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* 1. I am registering for the SMJ - BAR HARBOR

Tap Dance Program

Instrumental Program

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* 2. Please provide your best email, and cell # for TEXT use during our SMJ week.

Name

Email Address

Cell # Number

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* 3. In case of emergency, please contact:

Name

Phone Number (day and night)

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* 4. I am a ....

Hobbyist

Music Educator

Working Musician

College Student

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* 5. If you are new to Samba Meets Jazz Workshops, please share a little about your music and/or dance background.

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* 6. I will stay ...

On campus

Off campus

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* 7. If you are staying on campus, please select accommodation preferences

Private Room

Double Room

Double Room used as Single

Private Room with ensuite bath (if available)

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* 8. I will stay on campus and request the following meal plan

Standard Fare

Vegetarian

Vegan

Pescatorian

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* 9. I will stay on campus and have the following allergies ...

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* 10. If you are a commuter, would you like to opt-in for lunches (Mon-Friday)

YES

NOT SURE YET

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* 11. I am a full-time working musician or dancer in financial need and request consideration for discount ...

Yes

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* 12. I prefer to pay by:

Check

Venmo (no fee if drawn from your bank account or debit card)

Zelle (no fee)

Credit Card (3% surcharge)

PayPal (3$ surcharge)

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* 13. I will submit payment as follows:

Deposit (50%)

Full Payment

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* 14. I heard about Samba Meets Jazz Workshops via

Magazine Ad

Online - Facebook

Online - Other

Someone recommended