March Break Workshop Online Registration

March Break 2010 Online Registration

1. GENERAL INFORMATION:

Student First Name:
Student Last Name:
Age:
Gender:
Street Address/PO Box:
City/Town:
Province or State:
State (If Outside Canada/US selected above):
Country:
Postal/Zip Code:
Telephone:
Alt Telephone:
Email Address:
Parent/Guardian Signature (Required if student is under 19):
Registering for:
Student Type:
Room Type:
Preferred Roommate(s):
Please note: Single and double accommodations available to adults only. Youth are dorm only.

2. DISCIPLINE CHOICES:

1st Discipline:
1st Discipline Level:
2nd Discipline:
2nd Discipline Level:
3rd Discipline:
3rd Discipline Level:

3. VEGETARIAN MEALS:

4. MEDICAL REQUIREMENTS:

Please indicate any allergies, medications, etc.

5. SECURITY CODE:

Enter security code:

Please note: Upon clicking the "Submit" button below, you will be directed to the Gaelic College Craft Shop, where a $40.00 (Canadian) fee is required for processing your application. (The fee will be credited to your total cost.)

After fee processing is completed on our Secure Server, you will be contacted via e-mail by the Gaelic College Registrar within the next 5 business days. Please submit 1 registration form per person only.

The Gaelic College reserves the right to: (1) refuse any application; (2) take photos for promotional purposes.