Clone of OMPA Registration Form

OMPA Registration Form
Ensemble Name*
Address*

Street Address

Street Address 2

CityState

Postal / Zip Code
Director's Name*
Director's Email*
example@example.com
Director's Phone Number*
Please enter a valid phone number.
Director's NAfME #*
Registration for 1st Ensemble: Large ensembles include 8 or more students. Fees are $180.00 plus $2.00 per student. Small ensembles include 1-7 students. Fees are $10 per ensemble.

Registration for 2nd Ensemble: Fees are an additional $90.00 plus $2.00 per student.
Registration - 1st Ensemble (choose one)*

Large ensembleSmall ensemble
Number of Students*
Performance Grade Level*
1st Title*
Composer*
2nd Title*
Composer*
3rd Title*
Composer*
Registration - 2nd Ensemble

Large ensembleSmall ensemble
Number of Students
Performance Grade Level
1st Title
Composer
2nd Title
Composer
3rd Title
Composer
My ideal performance time is between:*
Please list the earliest time you can arrive and the latest time for your departure so that we can schedule accordingly.
Fees: Choose payment option below*

Check - please mail by March 31 or bring payment with you to OMPAPayPal - pay through PayPal or with debit/credit cardInvoice - I will send an invoice to you when you register for OMPA
My Products: You must check 2 boxes - the ensemble AND number of students to calculate the final fees.
prevnext( X )
1st Large Ensemble
8 or more students

$180.00 Quantity



Number of Students
$2.00 Quantity



1st Small Ensemble
1 - 7 students

$10.00 Quantity



2nd Large Ensemble
8 or more students

$90.00 Quantity



Number of Students
$2.00 Quantity



2nd Small Ensemble
1 - 7 students

$10.00 Quantity



Total

$0.00
loading smart payment buttons...

The payment is ready! It will be completed once you submit the form.
Should be Empty: