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					2009 CMI Registration
_____________________________________________                                       _____________________________________________
Name                                                                                E-mail


____________________________________________                                        ____________________________________________
SU ID # or SS#                                                                      Church


__________________________________________________                                  _____________________________________
Street                                                                              Daytime phone

__________________________________________________                                  _____________________________________
City                                              State          Zip                Mobile phone

Do you plan to stay in a university residence hall room?                            I am registering for:              Week I                       Week 2
 Yes        No                                                                    (check all that apply)                  (6/21 – 6/26)                (6/28 – 7/3)




On-campus Housing and Meals                                                         Please circle the dates below, indicating the evenings you plan
                                                                                    to stay in a residence hall.

 $50 per day            X        _______ nights          =   $ ___________         Week I:                          June        21         22      23 24 25 26
                                                                                    Week 2:          June                        28         29      30     1     2      3
                                                                                    Mid-CMI weekend: June                        26         27
includes on-campus residence hall accommodations                                    (only if attending both weeks)
and three meals.
                                                                                    Questions concerning housing:
                                                                                                             /
                                                                                    Rebecca Myers rmyers2@su.edu                              (540) 665-5445




Payment
_____________________________________________
Name
                                                                                    Cardholder’s address
Total for tuition                                             $ ________ (arst)     ___________________________________________________
($525/week)                                                                         Street

Materials packet                                              $ ________ (arst)     ___________________________________________________
($50/one week - $85/both weeks)
                                                                                    City                                                    State               Zip
On-campus Housing/Meal total                                  $ ________ (arst)
                                                                                    ___________________________________________________
$20 special application fee*                                  $ ________ (suapn)    Name as it appears on credit card (please print)


Total                                                         $ _________           Signature of cardholder (required)

Method of payment (please check one):
 Check        American Express                           Discover                X _________________________________________________
 MasterCard  VISA                                        Money Order
Amount of check or amount to be charged $_______________
(make check/money order payable to Shenandoah University)

                                                                                           Remit to:                                Deadline
                                                                                           Business Office                          The completed CMI registration
___________________________________________________                                        Shenandoah University                    and full tuition balance is due:
Card number                                                            Expiration          1460 University Dr.
 *Special application fee applies only to students who                                     Winchester, VA 22601                     June 3
  have never earned credit at Shenandoah University.

                                                                                                                                      For more information:
                                                                                                                                      www.su.edu/conservatory/cmi

				
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