Fall 2009 Winter 2010 Studio Course Application by sofiaie


									fa l l 2 0 0 9 / w i n T e r 2 0 1 0 a P P l i C aT i o n
PAy M E N T c h A R T F O R W I N T E R c O u R S E S :

Course length        Tuition        room & Board          additional charges             application fee
                                                          for single room                (non-refundable)
                                                          (subject to availability)

one week             $750.00        $520.00               $320.00                        $20.00

Please complete this application form and mail it to The Studio of The Corning Museum of Glass, One
Museum Way, Corning, NY 14830-2253. Applications made by credit card may be faxed to 607.974.6370.
There is no application fee for fall classes. Please include a $20 non-refundable application fee for one
or two winter courses. Use a separate application form and enclose a $20 non-refundable application fee
for each two additional winter courses.

Name ________________________________________________________________________________________

Address ______________________________________________________________________________________
City _________________________________________       State ___________        ZIP Code ____________________

Country ____________________________ E-mail __________________________________________________

Home # ________________________      Work # _______________________            Fax # _______________________


first Choice (include session #) _________________________________________________________________

 Fall       Winter      Date __________________      Instructor ______________________________________

Second Choice (include session #) ______________________________________________________________

 Fall       Winter        Date __________________ Instructor ______________________________________
 I would like to take both courses.
 If a course is (courses are) filled, I would like to be placed on a waiting list.

W I N T E R P R O G R A M O N Ly

 I would like housing.                         I am      Male     Female Age: ___________.
 I am attending with _______________________________________ and we wish to room together.
 I would like a single room. ($320 extra per week. availability not guaranteed.)

M E T h O d O F PAy M E N T

 Enclosed is a money order in the amount of $___________________.

  Enclosed is a check payable to The Corning Museum of Glass in the amount of $ ___________________.
Please charge to:    MasterCard     Visa    Discover   American Express

Name as it appears on card _____________________________________________________________________

Card number _____________________________________________ Expiration date ____________________
 Please charge my tuition and room and board to my credit card upon acceptance into a course.

 I’d like to contribute $___________ to the _______________________________________ Scholarship Fund.

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