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.Format: (000) 000-0000.
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.
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.
Signature
My Products
prevnext( X )
Pay Deposit Online
$50.00



Employer Will Submit Purchase Order or Training Authorization Form
Email documents to office@eaglehill.us.

Free



Will Mail Check
Please send any checks to: Eagle Hill Institute PO Box 9 Steuben, ME 04680

Free



Total

$0.00

Payment Methods

Should be Empty:

Online Seminar Application Form

My Products

Payment Methods