Anderson Ranch Arts Center Workshop Catalogs 2010-2014 | Page 77

Please print clearly. Use one form per student.

2013 SUMMER WORKSHOP APPLICATION
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, 2013.
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 attach another sheet for additional workshop choices if you would like to enroll in more than four 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

3rd Workshop

Workshop #

Workshop #

Instructor

Instructor

2nd Workshop

4th Workshop

Workshop #

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 deposits
less the registration fee ($55/Adult – $30/Child), a workshop cancellation fee ($100 per adult workshop; $30 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.

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:
(See page 71 for details)

o I wish to pay the Tuition Price.
o I wish to pay the Tuition + Studio Support Donation.

Deposit* ($300 per workshop) _________________
Housing Deposit ($100 per week reserved) _________________
Registration Fee ($55/Adult – $30/Child) _________________
Total Deposit Due _________________

FOR HOUSING PURPOSES

*If the tuition of the class
is less than $300,
then full payment is due
at the time of registration.

Please list any roommate or guest requests:
_______________________________
_______________________________
_______________________________
_______________________________

Payment