Online Seminar Application Form

Online Seminar Application Form

If you are applying for multiple seminars, a separate application form must be filled out for each of them. 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.
Full Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Company
Department
What seminar are you applying for?*
What are your specific interests, goals and expectations for the above seminar?
Which of your experiences, classes, or interests are related to the above seminars? What is your current career or career interest and institutional affiliation? If you have taken any seminars at Eagle Hill before, please list them here.
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 (15%; 30% with letter from advisor)None
Other pertinent information, comments, questions, etc., are welcome.
How did you first hear about the Eagle Hill Institute?
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 participants so they are able to review them or make up missed ones.*

Yes
Signature*

Clear
Options for Deposit
prevnext( X )
Pay Deposit Online
$50.00



Employer Will Submit Purchase Order or Training Authorization FormEmail documents to office@eaglehill.us.
$ Free



Will Mail CheckPlease send any checks to: Eagle Hill Institute PO Box 9 Steuben, ME 04680
$ Free



Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty: