Attendee Information
Name
Address
City
State AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY -Terr.- AS FM GU MI PR VI Zip Code
Phone(s)
Alternate Phone
Email
Workshop Fee Calculation
Workshop Fee
$ (1)
Workshop fee less any discounts and explain in the comments.
Services
$ (2)
Amount for additional services and explain in the comments.
Total Due
$ (3)
Enter the total of (1) plus (2).
Payments
$ (4)
If you are paying less than three months before the workshop date, enter the Total Amount Due in (3). Otherwise, enter $500.
Remainder Due
$
Enter the value in (3) minus the value in (4).
Payment Method
Bank Wire Check Credit Card
Comments
I have read and agree to the Registration Terms.
Authorized Signature
Date
Please make check payable to:
Sojourn In Italy
Mail to:
Sojourn In Italy P.O. Box 30130 Santa Barbara, CA 93130
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