GLIP Registration Form Class Dates: June 8 - 13, 2008 Last Name______________________________________________________ First___________________________________________________________ Male ______ or Female ______ (for room assignments only) Shirt Size_______________________________________________________ Address________________________________________________________ City____________________________________________________________ State __________________________________________________________ Zip_____________________________________________________________ E-Mail__________________________________________________________ Business Name__________________________________________________ Business Phone__________________________________________________ Years in Business ________ Full Time or Part Time Home Phone_____________________________________________________ Cell Phone_______________________________________________________ E-Mail__________________________________________________________ Do you wish to share a dorm room? _____Yes _____No - Add $125.00 If “Yes,” with Whom?_____________________________________________ 1st Choice Instructor_____________________________________________ 2nd Choice_____________________________________________________ Figuring your Tuition (must be paid in full by May 1st) Base Tuition:.............................................................................................$800.00 Single Room: add $125.00...............................................................................__________ Registration after May 1st: add $50.00.................................................................__________ Deduct any Scholarship (certificates or proof must accompany this application )...............................................__________ Total Tuition..........................................................................................__________ Scholarships awarded after the date of this application will be applied toward the final balance. Deduct Credits from Previous Year, Overpayment, or Other________.......................................__________ Tuition Balance with Deductions........................................................................__________ Required Registration Deposit for enrollment - $200.00 (must accompany this application)...............__________ Total Remitted with this Application...................................................................__________ Balance Due by May 1st.................................................................................__________ Deposit: Pay by Check #________________________ (make payable to Great Lakes Institute of Photography) Please charge my: MasterCard___ Visa___ Card No.__________ __________ _________ _________ Name on Card____________________________ Exp. Date___/___ Your Credit Card Statement Zip Code________________________ Signature of cardholder____________________________________ Please Note: Scholarships may not be used for Registration Deposits; they are to be applied only to your Final Balance. The undersigned hereby warrants that all policies and financial obligations stated above are understood and agreed to by the applicant, and that failure to meet said financial obligations in the manner prescribed will result in denial of admission to class. Paid in Full: Tuition must be paid in full by May 1st. Payments made after May 1st add $50.00. Cancellation Policy: Tuition for each course includes a $50.00 non-refundable registration fee. For cancellations less than fifteen calendar days from the starting date of school, all paid fees will be forfeited EXCEPT in case of emergency. In such instances, special consideration may be granted if applied for in writing with supporting documentation and submitted to the GLIP trustees for their consideration at their July meeting. Changing Classes before the start of School: Class Choice may be changed without penalty prior to May 1st. Changes after May 1st, ad $25.00. Applicant’s Signature______________________________ Date_______/_______/_______ For your security please print, then mail or fax this form to: Gregory J. Ockerman Treasurer/ Registrar Great Lakes Institute of Photography 1427 S. Milford Road Highland, MI 48357 Phone (313) 318- 4327 Fax (248) 889-5119 Email: gjodigital@aol.com