Anderson Ranch Arts Center 2015 Summer Workshop Catalog 1 | Page 98
Please print clearly. Use one form per student.
2015 summer workshop application
Anderson Ranch arts center
This application must be completed by all students (adults and children) either from this catalog or online.
Requests accepted on a first-come, first-served basis starting January 2, 2015.
STUDENT NAME _____________________________________________________________________________
MALE / FEMALE
MAILING ADDRESS _____________________________________________________________________________________________
CITY _____________________________________________________
STATE _________
ZIP CODE______________________
DAYTIME PHONE _______________________
EVENING PHONE ______________________
CELL _________________________
FAX _________________________________
E-MAIL ______________________________
BIRTH DATE____________________
IF THE STUDENT IS A CHILD PLEASE COMPLETE THE FOLLOWING: PARENT’S NAME _________________________________________
Please only list as many workshops as you hope to take; i.e., it is not necessary to provide backup choices. If a workshop is full, we will
place your name on the waitlist and will contact you to see if there are any other workshops that interest you. Please attach another sheet
for additional workshops if you would like to enroll in more than four classes.
1st Workshop
3rd Workshop
Workshop #
Workshop #
Instructor
Instructor
2nd Workshop
4th Workshop
W orkshop #
Workshop #
Instructor
Instructor
1st Choice
2nd Choice
3rd Choice
Housing
CANCELLATION POLICY: In order to cancel a workshop or housing
reservation and receive a refund, you must notify us at least 30 days
before the start date of your workshop or housing reservation. If we
are given the required 30 days’ notice, we will refund your deposit
less a workshop cancellation fee ($150 per adult workshop; $75 per
children’s workshop) and a housing cancellation fee ($50 per week
of housing reserved). No refunds will be issued for cancellations
made within 30 days of the start date of the workshop or housing
reservation. If we cancel a workshop, you have the option of
transferring to another workshop, based on availability, or we will
refund your payments in full.
______ I have read and I understand the cancellation policy.
(Please initial)
Meal Plan
Special Needs
o I do not have special needs
o I have special needs as follows: ____________________________________
Anderson Ranch tries to accommodate special needs of its students and
requires that each student inform Anderson Ranch of any special needs as part
of this registration. If no special needs are disclosed as part of this registration
form, Anderson Ranch may assume that you have no special needs and may rely
on this assumption for all purposes.
A deposit of $500 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 and will automatically be charged to the credit card on
file unless you make other arrangements prior to the due date. The exception is if the total cost of the workshop
(tuition, studio fee and registration fee) is less than $500, which is the case for weekend photography workshops and
children’s classes – then payment in full is due at the time of registration.
Please check one:
(See page 91 for details)
Payment method:
o I wish to pay the Tuition Price.
o I wish to pay the Tuition + Studio Support Donation.
o Check, Money Order or Cashiers Check enclosed
o Visa, MasterCard, American Express, or Discover
Card Number:______________________________________
Exp.___________
Cardholder’s Name _________________________________
FOR HOUSING PURPOSES
Please list any roommate or guest requests:
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
Signature_____________
I wish to make a tax-deductible donation of $ ________ to support a workshop scholarship.
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
96 andersonranch.org 970/923-3181
[email protected]