Village Music Circles™ Event Registration Form

Registration for Village Music Circles Hawaii Facilitators' Playshop is a two-step process. Use the form below to fill out your personal information and accomodation preferences. Upon submitting this form, you will be taken to our secure shopping cart to enter your payment information.

If you would like additional information, please contact our office. We’ll be happy to discuss our offerings or mail you our brochure.

Village Music Circles
719 Swift St., Suite 65
Santa Cruz, CA 95060
USA		 Phone: (831) 458-1946
Fax: (831) 459-7215
Email: teambuilding@drumcircle.com
Web: www.drumcircle.com
Playshops and Trainings
 
Playshops
 
*

 
Please choose the playshop for the location and date you are attending:

Click here to register for other trainings & playshops

Your Info
    * Required fields (but fill in as much as you can)
Your Name * first: last:
Gender * Female         Male      (needed for room assignments)
Bus Name  
Address*   street  apt or PO box
City*      State or province (Type N/A if in UK or Europe)
Zip or postal code:*   –      country: (Leave blank if US address.)
    For previous playshop participants:
 Update previous address data with this address?
   
  
Email*  

Phone*

(include area code)
 Cell (include area code)
Fax (include area code)
Profession
Educational Degree
Registration
Lodging
(Choose "does not apply" if your program does not include lodging)
Room  
Roommate? Name of preferred roommate, if any:
Meal Preference

Additional Info: I need a drum      I need linens
Do you have special needs?
Please describe your needs:
Discounts

Discounts

 

Level 1 or Level 2 returnees -  $75.00 off
Early Registration (before April 1, 2010 -   $50.00 off

Mentor Discounts

2nd Time Mentors  $400.00 off
3nd Time Mentors  $600.00 off

 


Educational Credits

Do you want
CE Units?

(Please check which type)   CEU     CMT     CMTE    NSW
  Music Therapist Certification No.
CEU Fees: $40 to Village Music Circles. Participant is responsible for fees paid to their professional organization.

Do you want Semester
Units ?
    Fee per unit is $10.00  
   
What is your purpose for
taking this training?
How did you find out
about this training?
Have you attended
other trainings?
Training:

 

 

Experience the uplifting power of rhythm!