In-Person Seminar Application Form

In-Person Seminar Application Form

If you are applying for multiple seminars, a separate application form must be filled out for each of them. Each application needs to be accompanied by either a $100 deposit, purchase order, or training authorization form. Deposits are credited towards costs for room, board, and tuition. The full balances is due upon arrival at Eagle Hill, or, in the case of purchase orders and training authorization forms, will be invoiced after the end of a seminar, unless requested earlier.
Full Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Company
Department
Age
Needed for room assignments.
Gender (for room assignments)
Needed for room assignments.
Emergency Contact*
Cannot be someone that is coming to Eagle Hill with you. Please include their name, phone number, and email.
What seminar are you applying for?*
What are your specific interests, goals and expectations for the above seminar?*
Which of your experiences, classes, or interests are related to the above seminar? What is your current career or career interest and institutional affiliation? If you have taken any seminars at Eagle Hill before, please list them here.*
Accommodation Choice*

Classroom Building RoomCabinLodgeStudent CabinTent PlatformCommuter
Do you have personal habits, preferences, or concerns that you would like us to be aware of?
Do you smoke or snore?

SmokeSnore
Do you have dietary restrictions and/or allergies we should be aware of? The full meal plan is required for anyone staying on the Eagle Hill campus. The commuter meal plan is required for commuters.*
Are you fully able to participate in field trips, some of which may involve hiking over uneven and/or awkward terrain? Please indicate any concerns you might have and how we might be able to help you.
Do you have medical conditions we should be aware of?
Are you requesting a general discount? Only one of the following may be requested.

Institute alumnus(a) of 1 previous seminar (10%)Institute alumnus(a) of 2-3 previous seminars (15%)Institute alumnus(a) of 4+ previous seminars (20%)University student (15%; 30% with letter from advisor)Couple (10%)Group (10%)None
Are you requesting a general scholarship? Scholarships range from 10 - 50%. The number of scholarships is limited. Why do you think you merit and need an award? How much are you requesting?
Other pertinent information, comments, questions, etc., are welcome.
How did you first hear about the Eagle Hill Institute?
I grant Eagle Hill Institute the permission to use any photographs taken of me during my participation in the above seminar(s) solely for the purposes of Eagle Hill Institute-related promotional material and publications.*

Yes
I understand that during my participation in this seminar, reasonable efforts will be made to assure my comfort and safety both at the host facility and in the field. I recognize my own responsibilities in this regard.*

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Options for Deposit
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Pay Deposit Online
$100.00



Employer will Submit Purchase Order or Training Authorization FormEmail documents to office@eaglehill.us.
$ Free



Will Mail CheckPlease send any checks to: Eagle Hill Institute PO Box 9 Steuben, ME 04680
$ Free



Total

$0.00

Payment Methods

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