Registration Form

____M s   _____M

Full Name   __________________________________Date of birth: ______________________

Address:     __________________________________________________________________

                    __________________________________________________________________

                    __________________________________________________________________

Tel:              __________________________    Mobile: ________________________________

Email         ___________________________________________________________________

                ___________________________________________________________________

Fees

____    Active Participant ($1,175) ______ Student ($850)

_____ Auditor for the entire class ($250) ______Student ($150)

____ _Audience member for .... Days ($30/ day) ____ Student ($20/day) in total.... $ ___________

Accommodation

_ I want to book a single room in                               ($60 night/person)

_ I want to share a double room in                              ($40 night/person)

_  I prefer to look for independent accommodation in Tzfat-Rosh Pinna

_______________________________________________________________________________

I am applying as an:  ______ Active Participant          _______ Auditor

If not selected as an Active Participant would you like to be considered as an Auditor?

___Yes _____No

______________________________________________________________________________

I read and agree with the terms and conditions (page 2) and confirm that the information given above is correct.

I  have transferred the deposit of $50   to the bank account.

I hereby officially register for the International Master Class for Conductors 6/7-10/72008

Place: ________________ Date: ____________________ Signature:    __________________