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. Enrollment and reservation forms may not be accepted after January 18, 2009 without prior agreement.
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:_____________________________
Signature (required) X _________________________________________________
BOOKING PERIOD(check workshop dates for which you are enrolling)
__From arrival in Cortona Saturday April 18, 2009 to departure Saturday April 25, 2009.
"Contemporizing Traditional Etruscan Jewelry" Accommodation Choice & Price Calculation
__Special Hotel Oasi Plan: Based on availability.
__$2849.00 per person Workshop Participant one week w/ private room/bath & Group Meal Plan.
__$2749.00 per person double occupancy/shared room for two Workshop Participants.
__$2549.00 per person Workshop Participant one week w/ private room/bath, no meal plan.
__$4798.00 double occupancy/shared room for one workshop Participant and one Non-participating guest.
__$2349.00 per person Non-Participant one-week w/ private room/bath, w/Group Meal Plan.
__$2049.00 per person Non-Participant one-week w/ private room/bath, no meal plan.
Four-star Villa Marsili, Hotel San Luca & Hotel San Michele quoted upon request
Total Due: $_______________
US$250.00 deposit per person due with enrollment form. If enrolling after April 18, 2009 please remit payment in full.
Checks accepted only. Make checks payable to: "Patrick J. Mahoney TA"
Authorized Signature________________________________________
Mail completed form to:
"Contemporizing Traditional Etruscan Jewelry" 2009
Patrick Mahoney/Toscana Americana Workshops
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 participants. Toscana Americana may cancel this workshop if the minimum number of participants is not met by January 18, 2009. In this case alternate dates may be offered or payments returned.