2013 Scholarship Organization Registration Form

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					                                2013 Registration Form
                        for organizations offering scholarships
Organization Name                      Contact Person                    Date

Address (for contact person in the organization)                         Email of contact person

City                                   State                             Zip Code             Country
Phone (day)                            Phone (evening)                   Phone (mobile)
Has your group offered scholarships to Hog Island in the past?           □ Yes      □ No     □ I don’t know
If so, in what year(s)?

Prices are per person in shared housing and include room, meals, and instruction. Please indicate how many
places for which you are registering in the program list below. Reserve a spot with a $100 non-
refundable deposit until full payment is due (see terms).
    __ Joy of Birding, June 9-14 $995                                      Early Bird Special: $50 off final
    __ Field Ornithology, June 16-21 $995                                  price for registrations received by
    __ Arts of Birding, June 23-28 $995                                           December 14th , 2012.
    __ Coastal Maine Bird Studies for Teens, June 16-21 $995                Excludes programs that require
                                                                               Road Scholar registration.
    __ Coastal Maine Bird Studies for Teens, June 23-28 $995
        Registration cost is $995 for organizations offering a scholarship of at least 50% of program cost
        ($495). Otherwise, the price for individual registration is $1295.
    __ Sharing Nature: An Educator’s Week, July 18-23 $995
    __ Family Camp, August 20-25 $995 per adult, $695 per child
    __ Fall Migration and Monhegan Island, Sept 15-20 $1295
    Registration for the spring (May 31-June 5) and fall (Sept. 8-13, Sept. 22-27) Road Scholar sessions are
    through Road Scholar. http://www.roadscholar.org/18493RJ or call 1-800-454-5768.

Participant information (if scholarship has been awarded; otherwise leave blank)
 Last Name                             First Name                    Date

 Address                                                             Email

 City                                  State                         Zip Code                 Country

 Phone (day)                           Phone (evening)               Phone (mobile)

 Previous camper at Hog Island?        Gender                        Birding experience
   □ Yes □ No                                                        □ Beginner             □ Inter-Adv.
 If yes, what year?                                                  □ Beg-Intermediate     □ Advanced
                                                                     □ Intermediate
 Age (at the time of camp session):
 Name of preferred roommate(s):
$100 nonrefundable deposit holds each reservation. Full balance for June/July programs is due by March
15th, remaining session balances are due July 15th. After these dates, remaining spaces will be filled on a
first-come first-serve basis with receipt of full payment. Please notify us when you have selected a
scholarship winner so we can send them a registration form and welcome packet. We would like to know all
scholarship winners by April 15th, 2013.

The registrar will issue a full refund (less $100 deposit) when a notice of cancellation is received in writing
up to 90 days before the start of the program. Half of a full refund (less $100 deposit) will be issued for
cancellation requests received in writing up to 30 days before the program. No refunds will be offered for
cancellations within 29 days of the program start date. See chart on below for dates. We strongly suggest
purchasing travel insurance to avoid expenses associated with an unexpected cancellation. Visit the website
http://hogisland.audubon.org for complete cancellation policy and suggested sources for travel insurance..

Refund schedule
                            Start     Full balance     Full refund (-$100     Half refund (-$100      No refund on
                            date          due         deposit) on or before   deposit) on or before     or after

Maine Seabird Biology
                             5/31                    See Road Scholar website for cancellation policies
and Conservation
Joy of Birding               6/9          3/15                3/11                     5/9                5/10
Field Ornithology &
                             6/16         3/15                3/18                     5/16               5/17
Teen Week
Arts of Birding & Teen
                             6/23         3/15                3/25                     5/23               5/24
Educator's Week              7/18         3/15                4/19                     6/17               6/18
Family Camp                  8/20         7/15                5/20                     7/18               7/19
Maine Seabird Biology
                             9/8                     See Road Scholar website for cancellation policies
and Conservation
Fall Migration               9/15         7/15                6/17                     8/15               8/16
Fall Migration               9/22                    See Road Scholar website for cancellation policies

❏ Check (Make check payable to: National Audubon Society) Amount to charge ($100 deposit or more)
❏ MasterCard             ❏ Visa
Card number                                                          Expiration date


Return form
Mail payment and this form to Hog Island Registrar, National Audubon Society, 159 Sapsucker Woods
Rd. Ithaca, NY 14850. For questions, contact the registrar at (607) 257-7308 x14 or email
See the website http://hogisland.audubon.org for answers to Frequently Asked Questions, directions and
more information about each program.

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