Your name:

Your telephone number:

Your email address:

(Please make sure there are no typos in your email address)

Which teacher would you like to have private lessons with? We will do our best to honor your request, depending on the demands of the schedule.
No preference
Susan Nowicki
Teresa Dybvig

Which clinic would you prefer to participate in on July 26?
No preference
Basic Movements
Shaping

Which clinics would you prefer to participate in on July 28? Select one from each row:

Would you like to schedule an extra Alexander Technique session with Diane Foust? You will also have an opportunity to sign up for an extra session during the week.
No, thank you
Yes, 25 minutes, fee $20
Yes, 50 minutes, fee $40

Would you like to play in the Performance class on improving concentration using tools from Don Greene's Performance Success (July 28)?
No
Yes

What kind of accommodation would you prefer?
I will not need University accommodation
University apartment, single (A/C, $395 for one person)
University apartment, shared (A/C, $197/person for two people).
     Please indicate in your message below if you have a preferred roommate.
University dormitory room, single (no A/C, $170 for one person)
University dormitory room, shared (no A/C, $85/person for two people).
     Please indicate in your message below if you have a preferred roommate.

If you have any dietary restrictions, please describe:

Would you like to participate in the evening riverboat cruise (including food and cash bar) on our night off, Tuesday July 29?
No
Yes, fee $26.50

Hold Harmless Agreement: Please read below and check.
I read, and agree to, the Waiver of Liability and Hold Harmless Agreement.

Your Message (optional):