MBIRA CAMP ENROLLMENT FORM

Name	___________________________________________________
Address	___________________________________________________
City/State/Zip	___________________________________________________
Country	___________________________________________________
Phone (cell)	___________________________________________________
Phone (other)	___________________________________________________
Fax	___________________________________________________
E-mail	___________________________________________________
Preferred session?	Hawaii Session: watch for 2013 dates to be announced
	Berkeley Summer Session 1: 7-14 July 2012
	Berkeley Summer Session 2: 21-28 July 2012
	Berkeley Summer Session 3: 10-17 August 2012
	Argentina Session: 15-22 September 2012
Playing level?	First Time
	Beginning
	Intermediate
	Advanced

All Sessions: Please enclose your $450 non-refundable deposit or full fee ($800 for California Session 2 and 3, $850 for California Session 1, Hawaii, Argentina) . $50 Discount for full payment by session deposit due date: $750 instad of $800, $800 instead of $850. Deposit due dates are Berkeley sessions April 1st, Hawaii Oct. 1st, Argentina June 1st.

Enrollment form without deposit does not save your space. Make out check or money order payable in US$ to MBIRA and send with this form to MBIRA, Box 7863, Berkeley, CA 94707-0863, USA. ***YOU CAN NOW PAY ONLINE FOR CAMP THROUGH CHASE QUICKPAY TO MBIRA (erica@mbira.org) - THIS IS FREE! (can be used to pay from US bank accounts only - does NOT require an account with Chase)

You can pay by wire transfer from outside the US, but you will have to pay the wire fee, and the $15 fee our bank charges to receive it. There is a additional 6% processing fee if you pay through Paypal to MBIRA (erica@mbira.org). Payment is non-refundable unless a student on the waiting list is able to take your place (usually not possible for late cancellations).

For more info, call Erica at (510) 548-6053 or email camp@mbira.org

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