s p r i n g / s u mm e r 2 0 1 1 A p p l i c a t i o n Course Length Tuition
Room & Board
Additional charges for single room
Application fee (non-refundable)
(subject to availability)
-
One week
$750.00
$520.00 + sales tax = $561.60
Two weeks
$1,400.00 $1040.00 + sales tax = $1123.20
$320.00 + sales tax = $345.60
$20.00
$640.00 + sales tax = $691.20
$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 607.438.5150. There is no application fee for spring classes. Please include a $20 non-refundable application fee for one or two summer courses. Use a separate application form and enclose a $20 non-refundable application fee for each two additional summer courses. Name ________________________________________________________________________________________ Address ______________________________________________________________________________________ City _________________________________________ State ___________ ZIP Code ____________________ Country ____________________________ E-mail __________________________________________________ Home # ________________________ Work # _______________________ Fax # _______________________ Course S ele c t ion First Choice (include session #) _________________________________________________________________ Spring Summer Date __________________ Instructor _________________________________ Second Choice (include session #) ______________________________________________________________ Spring Summer Date __________________ Instructor _________________________________ I would like to take both courses. If course(s) is (are) filled, please place me on a waiting list. S CH O L A R S H I P A P P L I C A T I O N S O N LY Check all that apply (incomplete applications will not be considered): If I don’t receive a full scholarship, I still want to take the class, and I will pay the entire fee myself. If I don’t receive a partial scholarship, I still want to take the class, and I will pay the entire fee myself. (Partial scholarships range from $250 to $1,000.) If I don’t receive a full scholarship, I will be unable to take the class. S U M M E R P rogram only 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 + sales tax = $345.60 extra per week. Availability not guaranteed.) M e t h o d o f P a y men 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 ____________________ If you check this box, we will charge your tuition and room and board to your credit card upon acceptance into a course. I’d like to contribute _________________ to the ___________________________________ Scholarship Fund.
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