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]