Workshop Registration

To register we require:

$55 nonrefundable application fee (once per calendar year)
$300 course deposit ($600 on destination classes)
$100 lodging deposit per course (if booking)

Billing will be sent via email for balance due.

Course: Learning to See
Dates:June 6th - June 12th 2010

Personal Information

First Name: *

Last Name: *

Gender: *

Male

Female

Age:

Address/PO Box: *

City: *

State/Prov.: *

Zip/Postal Code: *

Country: *

Home Phone:

Example: 1-123-456-7890 or +1234567-89012

Work Phone:

Cell Phone:

Email: *

FAX:

Occupation:

Company:

Is your employer sending you?:

Yes

Resume for Film Students:

If you are taking a film class, please upload your resume (please make sure it is a .PDF or .DOC file)

Additional Information

How did you hear about Maine Media?:

Alumni Peer Network Group:

By checking this box, you will automatically be entered into our Workshops Alumnae Peer Group Network. Your name, phone number and email address will be made available to others from your community who have made the same election and wish to form contacts in their area. If you wish to not participate in this program, simply un-check the box.

Special Instructions:

Billing Information

Cardholder's Name: *

(enter as it appears on credit card)

Billing Address: *

City: *

State/Prov.: *

Zip/Postal Code: *

Country: *

Card Type:

Card Number: *

Expiration Date: *

Security Code: *

3 or 4-digit number on the back of the card, or above the imprinted card number on the front.

Acknowledgment: *

I have read and understand the full course description(s) and requirements for all courses for which I am registering.

Accommodations

Applies only to classes held in Rockport.

Will you be coming with a companion?:

Yes

If yes, a fellow student?:

Yes

Companion's Name:

Shall we reserve your room?: *

Yes

Room type:

Meals are required of all students and is included in the lodging pricing. For those students not reserving lodging, the meal plan cost is $240 per week and includes all meals from Sunday dinner through Saturday brunch.

ROOM TYPES: Campus Residence | Standard Accommodations | Deluxe Accommodations | Economy Accommodations

Reserve an airport shuttle?: *

Yes

Maine Media Workshops admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and other school-administered programs.

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