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| NEVERSINK WORKSHOP APPLICATION |
| Fill out, sign, and mail with deposit to: LOUIS JAWITZ 13 East 17th Street New York, New York 10003 (Make check payable to Louis Jawitz) |
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| NAME: _____________________________AGE:___SEX: ___ ADDRESS: _______________________________________ CITY: ________________________STATE: ____ZIP: _____ DAYTIME PHONE: __________________________Ext:____ EVENING PHONE: __________________________ MOBILE: __________________________________ |
| DATES YOU PLAN TO ATTEND: Full Workshop: ___August (Please indicate dates desired) ___August |
| SINGLE DAY SESSION: Indicate date desired:___August ___ ___ ___ ___ |
| LEVEL OF PHOTOGRAPHIC SKILL:_______________________ CAMERA FORMATS USED:______________________________ INTERESTED IN ________COLOR ________BLACK AND WHITE HOW DI D YOU HEAR ABOUT THE NEVERSINK PHOTO WORKSHOP? _____________________________________________________ |
| AMOUNT ENCLOSED (50% deposit required per person) ________________ BALANCE DUE:_______________________________ |
| Applicant agrees to the terms stated in the workshop description. Additionally,
applicant releases the workshop sponsors staff, contractors, carriers, and agents of liability in
case of accident or loss to person or property during the workshop or while travelling to or
from the workshop Applicant assumes all risks involved. The workshop reserves the right to subsitute instructors. |
| APPLICANT'S SIGNATURE__________________________________________ |
| THE NEVERSINK PHOTO WORKSHOP 212.929.0008 OR 845.434.0575 |
| Click Here for Neversink Workshop Map. |
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| © 2006 Louis Jawitz |
| 212.929.0008 |
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