Application for Eagle Hill Online-only Mini-seminars

If this form is successfully submitted, you will receive an email verification of the information you submitted. If you do not receive verification within 2 business days, please contact us at office@eaglehill.us to resolve the issue. (however, please check your email's Junk and Spam folders to be sure the confirmation message did not get filtered out of your Inbox).

Registrations for most seminars are welcome up to two business days before they begin. Please do not register for seminars that have already begun.

* Denotes required fields

* Full Name
* Phone (day)
Phone (cell)
* Address
* City
* State/Province
* Zip/Postal Code
* Email
I would like to participate in the following online mini-seminar(s):

* First title
* Instructor
* Dates

Second title
Instructor
Dates

Third title
Instructor
Dates
What are your specific interests, goals and expectations for the above mini-seminar(s)?
Which of your experiences, classes, or interests are related to the above programs? What is your current career or career interest and institutional affiliation?
Are you requesting a general discount? Only one of the following may be requested. Institute alumnus(a) of 1 previous seminar (10%) Institute alumnus(a) of 2-3 previous seminars(15%) Institute alumnus(a) of 4+ previous seminars(20%) University student(10%); with faculty letter of recommendation(20%)
If you are a student, please list your university or college. If you are an alumnus, please list seminars you have attended.
Comments, other infomation, and questions, etc., are welcome:
Each application needs to be accompanied by a $50 online deposit. We first send a brief acceptance email. We follow up with a full acceptance email, along with a balance statement. This needs to be paid upon receipt to confirm your place in the seminar. Deposits are returned when a seminar is full or canceled. They can be made by credit card by way of our PayPal portal after filling out your online application. No PayPal account is needed.
I will participate in the seminar(s) with the understanding that individual classes will be recorded and made available for the duration of the seminar only to its partipants so they are able to review them or make up missed ones.
How did you hear about Eagle Hill?
*Signed (type your name)
*Dated

E-Commerce site required information ... Contact information - Eagle Hill Institute, PO Box 9, Steuben, ME 04680-0009. Customer service: 207-546-2821 # 1, or office@eaglehill.us.Refund policy: See ... https://www.eaglehill.us/programs/general/application-info.shtml. Privacy statement: We know that you care how information from you is used. We do not share your information with others.