Anderson Ranch Arts Center Workshop Catalogs 2000-2009 | Page 55

Please print clearly. Use one form per student. 2009 SUMMER WORKSHOP APPLICATION – This application must be completed by all students (adults and children) either from this catalog or online. Adult applications received by January 23, 2009 and children’s applications by February 27, 2009 will be included in the early application process; applications received after January 23, 2009 and February 27, 2009 will be registered on a space-available basis. STUDENT NAME______________________________________________________ DAYTIME PHONE____________________ EVENING PHONE____________________ MAILING ADDRESS____________________________________________________ CELL_____________________________ E-MAIL___________________________ CITY_______________________ STATE_______ ZIP CODE_______________ FAX______________________________ IF THE STUDENT IS A CHILD PLEASE COMPLETE THE FOLLOWING: PARENT’S NAME____________________________________ BIRTH DATE________________________ MALE / FEMALE Please indicate your first, second and third choices for each workshop you would like to enroll in. Please attach another sheet for additional workshop choices if you would like to enroll in more than three classes. Also indicate if you are hoping to attend with friends or a family member. We will do our best but cannot guarantee your request. 1st Workshop 1st Choice 2nd Choice 3rd Choice 1st Choice 2nd Choice 3rd Choice Workshop # Instructor 2nd Workshop Workshop # Instructor 3rd Workshop 1st Choice 2nd Choice 3rd Choice 1st Choice 2nd Choice 3rd Choice Workshop # Instructor Housing Meal Plan Deposits will be due upon acceptance into workshop(s) and housing to hold your space. The balance is due in full 60 days prior to the start of your first workshop. We will automatically charge your balance to the credit card on file unless you have made other arrangements prior to the due date. Please check one: o  I wish to pay t