APPLICATION
October 8-12, 2009
NAME_____________________________(spouse/partner)__________________
STREET____________________________CITY_______________________________
STATE___________________ZIP______
PHONE_____________________________
EMAIL______________________________
COST: $325.00/student. For reservations, a $100.00 deposit is required.
I/we have enclosed_________($100.00 per caller) deposit and understand the
balance is due at time of registration.
Make checks payable to:
Ken Ritucci
132 Autumn Road,
West Springfield, MA 01089
Phone: 413 734-0591 Email: kenritucci@aol.com
Canadians please remit U.S. Funds