Enrollment Form
(Please print, complete and mail this form.)
To confirm a reservation it is necessary that this form is filled in and signed, then mailed to us with the necessary payment. Enrollment requests are processed on a first-received basis. Due to enrollment limitations we may not be able accept all requests for enrollment. In this case we may offer you alternate dates which you may elect to accept or decline within seven days.
PARTICIPANT INFORMATION
(List all participants and non-participants separately and include with this form)
Contact Name________________________________________________
Address_____________________________________________________
City__________________________ State__________ Zip Code________
Country______________________________________________________
Telephone-Day_______________ Telephone-Evening_________________
Email__________________________ Fax__________________________
Emergency Contact phone number: ____________________________
Special or dietary needs:_____________________________
*I have read and agree to the Enrollment Terms & Conditions (See below.)
Signature (required) X _________________________________________________
BOOKING PERIOD
__From arrival in Fira, Santorini Wednesday October 5, 2011 to departure Wednesday October 12, 2011.
Preferred Hotel (Avalabiltiy limited): ____ Hotel Nissos Thira
(note: Other hotels may be used)
Toscana Americana "Painting Acrylic en Plein Air: Santorini" Price Calculation
*Group Meal Plan (GMP): Includes daily lunch, dinner, wine tasting.
ECONOMIZE! Choose NO MEALS and deduct US$350.00 from any of the above Plans!
Total Due: $_______________ (Payment due in full by June 5, 2011)
US$250.00 deposit per person due with enrollment form.
Total Deposit Due: $_________
Preferred Payment Method (See Enrollment Terms & Conditions below)
Checks accepted only. Make checks payable to: "Patrick J. Mahoney TA"
Authorized Signature________________________________________
Mail completed form to:
"Painting Acrylic en Plein Air: Santorin" 2011
Patrick Mahoney/Toscana Americana
367 West Broadway
Gardner, MA 01440
USA
All enrolled participants will receive written confirmation and further workshop information. This workshop is offered based on a minimum number of eight participants. Toscana Americana may cancel this workshop if the minimum number of participants is not met 90 days prior to intended workshop start date. In this case alternate dates may be offered or all payments returned.
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