Your name:

Your street address:

Your city and zip code:

Your home telephone number:

Your cell telephone number:

(We may need this to reach you during the session)

Your email address:

(Please make sure there are no typos in your email address)

Which Special Package would you like to attend?
For pianists with dystonia
Combination private piano instruction and private Aston-Patterning

Which teacher would you like to have private lessons with? We will do our best to honor your request, depending on the demands of the schedule.
No preference
Susan Nowicki
Teresa Dybvig

Which clinic would you prefer to participate in on Friday, July 20? Select one:
Introduction to Basic Movements
Engaging the Palm
Please help me decide which clinic would be best for me.

Which clinics would you prefer to participate in on Sunday, July 22? Select one from each row. If you select "no preference," we will try to choose the best clinic for you:

Would you like one of your students to play for Susan Nowicki during her performance class for children on Sunday morning?ss (There is no fee for the performer).
No
Yes

Would you like to schedule a private Aston-Patterning session with Judy Huston? You will also have an opportunity to sign up for an extra session during the week, but be aware that these sessions fill quickly.
No, thank you
Yes, 60 minutes, fee $70

Would you like to schedule a private Feldenkrais session with Bob Schlesinger? It's best to register for this now.
No, thank you
Yes, 60 minutes, fee $70

Would you like to play in the Performance class (July 23)?
No
Yes

Do you need to stay in university housing?
No
Yes

If you would prefer shared university housing, please indicate your gender:
Female
Male

If you have any dietary restrictions, please describe:

Your Message (optional):