WORKSHOP APPLICATION Lessac Summer Intensive Workshop 2010 DePauw University   Name:    Address: City:          State:     Zip: Cell Phone:    Home Phone: Work Phone: Email Address: Training/Experience with Lessac Training: Are you presently teaching?  CHOOSE Yes No   If yes, where?: Are you presently studying?  CHOOSE Yes No   If yes, where?: If you do not teach or study, what is your current professional activity? A $100.00 deposit is due with application for admission. A full refund of this deposit is granted if not accepted into the program. ½ deposit is refundable if after acceptance you must cancel, and you notify the program coordinator before May 1. For those accepted into the Workshop, the deposit will be deducted from your tuition fee. After notification of acceptance, tuition and fees are due by May 15. AFTER YOU SUBMIT THIS FORM, RETURN TO THE WORKSHOPS PAGE TO PAY VIA PAYPAL.

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