Group
Registration Form
~ Please type ~


Faculty Name: _______________________________________________________________________

School: ____________________________________________________________________________

Address: ___________________________________________________________________________

City, State, Zip: ______________________________________________________________________

E-mail & Phone: _____________________________________________________________________

Registration Fees: $30 for full conference or $15/day

    Student Name                          Phone                   E-mail                           Instrument          Reg. Fee

1. ________________________ ______________ ___________________ _____________ ________

2. ________________________ ______________ ___________________ _____________ ________

3. ________________________ ______________ ___________________ _____________ ________

4. ________________________ ______________ ___________________ _____________ ________

5. ________________________ ______________ ___________________ _____________ ________

6. ________________________ ______________ ___________________ _____________ ________

7. ________________________ ______________ ___________________ _____________ ________

8. ________________________ ______________ ___________________ _____________ ________

9. ________________________ ______________ ___________________ _____________ ________

10. _______________________ ______________ ___________________ _____________ ________

11. _______________________ ______________ ___________________ _____________ ________

12. _______________________ ______________ ___________________ _____________ ________

13. _______________________ ______________ ___________________ _____________ ________

14. _______________________ ______________ ___________________ _____________ ________

Use back of form for additional names.
Send forms to:
GPRTEC c/o Susan Hathaway, UMKC Conservatory of Music, 4949 Cherry St., Kansas City, MO 64110
Make checks payable to UMKC