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 less than 60 days prior to workshop start dates 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:_____________________________
*I have read and agree to the Enrollment Terms and Conditions (see below).
Signature (required) X _________________________________________________
BOOKING PERIOD
__From participant check-in in Rome Wednesday October 14, 2009 to conclusion upon arrival in Rome Thursday October 22, 2009.
Toscana Americana "V Brooks Plein Air Capri, Positano & the Amalfi Coast" Price Calculation
(All Plans based on availability):
Plan A: Nine days/eight nights private or shared room w/Group Meal Plan* (GMP) ...…
....$2999.00 single occupancy, 1 workshop Participant
Plan B: Nine days/eight nights shared room w/GMP (2 Workshop Participants).....
....$5798.00 double occupancy
Plan E: Nine days/eight nights, 1 Workshop Participant & 1 Non-participant, w/GMP......
....$5398.00 double occupancy
Plan G: Nine days/eight nights, each added non-participant, w/GMP…..
....$2599.00 single occupancy
*Group Meal Plan (GMP): Includes daily 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 July 14, 2009)
US$250.00 deposit per person due with enrollment form.
Total Deposit Due: $_________
Preferred Payment Method (See Enrollment Terms and Conditions below )
Checks accepted only. Make checks payable to: "Patrick J. Mahoney TA"
Authorized Signature________________________________________
Mail completed form and deposit/payment to:
"V Brooks Plein Air Capri, Positano & the Amalfi Coast"
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 12 Workshop Participants.
We look forward to
"Plein Air Capri, Positano & the Amalfi Coast"
with you!
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