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Toscana Americana Workshops
presents
“Acrylic Media and Textures... Italian Style”
with Jacqueline Sullivan
Cortona, Italy October 22-29, 2008
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Enrollment
(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-recieved basis. Due to enrollment limitations we may not be able acept 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 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 & Reservation Terms and Conditions.
Signature (required) X _________________________________________________
BOOKING PERIOD(please choose)
__ From arrival in Cortona Saturday October 22, 2008 to departure Saturday October 29, 2008.
"Acrylic Media and Textures… Italian Style" Accommodation Chioce & Price Calculation
__Special Hotel Oasi Plan: Based on availability.
$2749.00 per person Workshop Participant one week w/ private room/bath & Group Meal Plan.
$2649.00 per person double occupancy/shared room for two Workshop Participants.
$2449.00 per person Workshop Participant one week w/ private room/bath, no meal plan.
$4598.00 double occupancy/shared room for one workshop Participant and one Non-participating guest.
$2249.00 per person Non-Participant one-week w/ private room/bath, w/Group Meal Plan.
$1949.00 per person Non-Participant one-week w/ private room/bath, no meal plan.
Three-star Hotel Plans(based on availability, other hotels may be used):
Check your first and second choice: Hotel Italia_____
__Hotel Plan A: Workshop Participant one-week w/Group Meal Plan* (GMP) ....$2899.00 single occupancy
__Hotel Plan B: Workshop Participant one-week, no meals.….................$2599.00 single occupancy
__Hotel Plan E: One-week, 1 participant & 1 non-participant, w/GMP.....$5098.00 double occupancy
__Hotel Plan F: One-week, 1 participant & 1 non- participant, no meals...$4498.00 double occupancy
__Hotel Plan G: One-week, each added non-participant, w/GMP………..$2499.00 single occupancy
__Hotel Plan H: One-week, each added non-participant, no meals…….....$2099.00 single occupancy
*Group Meal Plan (GMP): Includes daily Italian breakfast, lunch, dinner, wine tasting.
Four-star Villa Marsili, Hotel San Luca & Hotel San Michele quoted upon request
Total Due: $_______________ (Payment due in full by July 22, 2008)
US$250.00 deposit per person due with enrollment form. If enrolling after July 22, 2008 please remit payment in full.
Preferred Payment Method (See Enrollment & Reservation Terms and Conditions)
Checks accepted only. Make checks payable to: "Patrick J. Mahoney TA"
Authorized Signature________________________________________
Mail completed form to:
"Acrylic Media and Textures… Italian Style" 2008
Patrick Mahoney/Toscana Americana Workshops
367 West Broadway
Gardner, MA 01440
USA
All enrolled participants will recieve written confirmation and further workshop information. This workshop is offered based on a minimum number of participants. Toscana Americana may cancel this workshop if the minimum number of participants is not met by July 22, 2008. In this case all payments will be returned.
We look forward to your participation in
"Assemblage & Encaustic Arts" in Cortona!
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