Rollo Dilworth Workshop Registration Form

Rollo Dilworth Workshop Registration

Complete form below to signup for the workshop.
Name

First Name Last Name
Preferred Pronoun
School/Community or Faith-based setting
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Preferred E-mail
Preferred Phone

Area Code Phone Number
What age level do you teach? Check all that apply:

Elementary Middle School High School College / Adult
In what setting do you teach? Check all that appy:

Public School Private School Charter School Faith Based Setting

Please register me for the following Rollo Dilworth Choral Workshops:

Thursday, March 28, 2019 Choral Masterclass (2 hours ACT 48 credit) $ 25.00

Quantity

Saturday, March 30, 2019 Choral Workshop and Demonstration Choir Model (5 hours Act 48 credit) $ 35.00

Quantity

Optional Boxed Lunch. Select choice below. $ 12.00

Enter coupon

Total $ 0.00

If attending the Thursday Conducting Masterclass. Please check if you are interested in working with Rollo Dilworth.

I would like to be considered as a conducting candidate
Optional Lunch for Saturday Workshop. Boxed lunch includes sandwich wrap, chips, salad, cookie, fruit, and beverage. $12
Please select your wrap choice
How did you hear about the workshop?

Web Site Friend/Colleague Online Search
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