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To apply for this intensive, submit the following items along with your completed registration form and payment-in-full. Please submit all items together at the time of application.
We are sorry that incomplete applications cannot be accepted.
New Students: If this is your first intensive with Rosalyn and Ken, please provide the following additional typed information with your registration, limiting your answers to 1-2 paragraphs per question.
Name_______________________________________________
Address_____________________________________________
City________________________________________________
State/Prov_____________Zip____________________________
Home Phone__________________________________________
Work phone__________________________________________
Email_______________________________________________
Name for ID Tag______________________________________
Emergency Contact Name__________________________________
Emergency Contact Phone#__________________________________
$700 Early Bird Workshop Fee (Payment due by June 21) $750 Regular Workshop Fee
Check # ______ payable to HLCC and/or
MC Visa Disc AMEX CC#____________________________________ Security Code (3 digit code on back):______ Ex. Date:__________
To register for this workshop please fill out the form above and mail it along with your payment, AND color photo to the following address.
Shannon Winsky c/o HLCC 261 E. Alegria Ave #12 Sierra Madre, CA 91024
OR,
Email s.winsky3@gmail.com to register with email, please copy and past this registration filled out completely.
Questions? Please feel free to phone Shannon at (626) 602-4642.