Registration Form

Registration

Ainm (Name) _________________________________

Seòladh  (Address)   _______________________________

                                   _______________________________

Fòn (Phone) _____________________________

Post-d (email) ____________________________

Ainm Gàidhlig (Gaelic name) _______________

Language level____________________________

ACGA Policy: Students under 18 are welcome. However, if they intend to stay overnight, a parent, or parent-appointed guardian, must accompany them. Guardians must submit a signed parental agreement to that effect. Please request form if under 18.

Cost for the week: (Check one option only)

PR = tuition, private room, meals

DS = day student, tuition only, no meals

FM= family member not attending classes (lodging, meals, but no tuition)

Sunday dinner thru Friday lunch

ACGA Members Non-members

PR $425 ____ $450 ____

DS $230 ____ $255 ____

FM $260 ____ $285 ____

To become a member of ACGA, go to the following link:

http://www.acgamerica.org/join-acga

Will you need to rent linens? (Those who drive are encouraged to bring their own.

No_____Yes_____

($25.00 will be due upon arrival at college.

Do not add to fees.)

Van service from Charlotte Airport to Banner Elk, NC can be obtained by contacting:

Air Haven Limo
dana@airhavenlimo.com
Phone: 828-265-2504

Assisted access required? yes ____ no ___

Fee Total $ ________

(from previous column)

Donation to ACGA $__________

Total Fees $ _________

(includes a $25 non-refundable fee for cancellation)

Total Enclosed $__________

A deposit of at least 50% must accompany this registration.

Balance due $ ________

If balance is postmarked by midnight May 15 you may take a discount of $20.00 off of the total.

Please make checks payable in U.S. funds to “ACGA”

Please print this registration form & mail registration & check to:

ACGA IW/GMS&LW
c/o Rudy Ramsey, Registrar
7644 E. Lakecliff Way
Parker, CO 80134-5933