2020 Teachers Workshop Application
August 10 - 14, 2020

One application per student only. Application instructions are available on

NEW students should complete this form in it's entirety.

RETURNING students (those who attended or applied for a 2017-2019 CPYB summer program), click on the red link above to login to your Family Portal BEFORE completing this form for your existing account to be recognized. Please contact CPYB at 717.601.2840 if you need assistance with your username and password. Again, one application per student only.

Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact (Include name, address, phone number, e-mail)*
Students entered below will be added to your family's account
How did you hear about the Teachers Workshop? (please see categories within the instructions)
Do you have zero-one year of teaching experience?*
How many years have you been teaching?
CURRENT/MOST RECENT TEACHING EXPERIENCE: Name of School, include city and state.
CURRENT/MOST RECENT TEACHING EXPERIENCE: Start and end date of your current or most recent teaching employment
Do you have professional dance experience?*
PROFESSIONAL DANCE EXPERIENCE: Name of company, position and years
Please share any other pertinent information such as awards and/or other teacher/dance experience you'd like for us to know. (50 words or less)
TUITION OPTION 1: My application is dated on or before April 1 and eligible for a $1,000 tuition rate. The balance of $700 will be processed on April 15, 2020. (checked=yes)
TUITION OPTION: My application is dated on or before May 1 and eligible for a $1,100 tuition rate. The balance of $800 will be processed on May 15, 2020. (checked=yes)
TUITION OPTION: My application is dated on or before June 1 and eligible for a $1,200 tuition rate. The balance of $900 will be processed on June 15, 2020. (checked=yes)
TUITION OPTION: My application is dated after June 1. I understand the tuition rate is $1,200 and the full program fee will be charged within 48 hours of my acceptance into the program. (checked=yes)
Additional Information:
1. I acknowledge the CPYB Teachers Workshop Orientation and Welcome Reception is Sunday, August 9 and workshop observations and sessions are August 10-14. I acknowledge CPYB does not provide housing accommodations during the Teachers Workshop.
I've read the above and agree.
I acknowledge at the time of application submission, a non-refundable $85 application fee, and $355 non-refundable deposit and security fee will be charged to the financial information provided by the applicant in the application or in their Family Portal (returning student).

I acknowledge that the remaining balance for tuition will be charged to my account based on the selected/eligible date within this application.

I've read the above and agree.
I understand cash is not accepted as a form of payment. All application fees and tuition must be via credit card provided with this application or in the Family Portal. CPYB accepts Visa, MasterCard and Discover.

I understand that it is my responsibility to notify the financial institution due to limits on my account or fraud prevention. I understand that transactions declined for any reason incur a $35 declined transaction fee. ONLY if a letter from the financial institution stating the account was closed due to fraud is provided within 48 hours prior to the payment being processed will the $35 declined transaction fee be waived. Please visit to access the Refund Policy.

I've read the above and agree.
I have read, understand and agree to the Refund Policy as outlined at I understand there are no exceptions to the Refund Policy and all fees posted and paid through the submission of this application are non-refundable and non-transferable to any student or other CPYB program.
I've read the above and agree.
I hereby authorize CPYB to record the student's picture and voice on photographs, films, live stream, and tapes, to edit these recordings at its discretion, and to incorporate these recordings into movie and sound films on tapes, radio, and television and online broadcast programs. I also give my permission for CPYB to use and license others to use these materials in any manner or media whatsoever. CPYB is permitted to use these materials for publicity, advertising and sales promotion and to use the student's name, likeness and voice and biographic or other information in connection with them. I acknowledge that no promises of compensation were made by CPYB for such use. This release is valid for the duration of the student's enrollment at CPYB.
I've read the above and agree.
My electronically typewritten signature below shall be legally binding and serve in the same capacity as my original penned signature.
I've read the above and agree.
Enter your Full Name: *   
Other Questions/Comments:
Credit Card Verification:
Card Number: *  
Name as it appears on card: *
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*