Anderson Ranch Arts Center Workshop Catalogs 2000-2009 | Page 47

Please print clearly. Use one form per student. 2008 SUMMER WORKSHOP APPLICATION – Adult applications received by January 22, 2008 and children’s applications by February 29, 2008 will be included in the early application process; applications received after January 22, 2008 and February 29, 2008 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 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. 1st Choice 2nd Choice 3rd Choice Workshop # Instructor 2nd Workshop Deposit* ($250 per workshop)__________________ Workshop # Housing Deposit ($100 per week reserved)__________________ Instructor Registration Fee ($45/Adult – $30/Child)__________________ 3rd Workshop *If the cost of the class is less than $250, then full payment is due as the deposit. 3rd Choice Workshop # Instructor 1st Choice 2nd Choice 3rd Choice Housing Total Deposit Due__________________ o  Check, Money Order or Cashiers Check enclosed 2nd Choice Payment Method: 1st Choice o  Visa, Mastercard or American Express Card Number:______________________________________ Exp.__________________ Cardholder’s Name_________________________ Signature_______________________ Meal Plan FOR HOUSING PURPOSES Please describe physical limitations (walking, stairs, etc.) and/or any roommate or guest requests: Mail this form with payment to Anderson Ranch Arts Center, PO Box 5598 (USPS), 5263 Owl Creek Rd. (UPS, FedEx, etc.), Snowmass Village, CO 81615 – or fax this form to 970/923-3871 CANCELLATION POLICY: In order to cancel a workshop or housing reservation and receive a refund, you must notify us at least 30 da