Name__________________________________________________________
(please print or type name as it appears on passport)
Address_______________________________________________________
City___________________________ State__________ Zip___________
Email ________________________________________________________
Phone: Home( )____________________ Work ( )___________________
Fax ( )______________________ Cell Phone ( ) _________________

Option # ________
Passport # ____________________________________________
(passport # required prior to 30 days before departure)
Male ____ Female _____
Non-smoking _____ Smoking _____
Age Group: under 18 __ 19-25 ___ 25-40 ___ 41-60 ___ 60-75 ___ over 75 ____
Do you speak French? Yes _____ No ______ (applies only to FOMS participants)
Double Accommodation _____ Single Accommodation at TBD per night ______
Accompanying Spouse/Friend/Roommate__________________________________
We will assign you a roommate if you do not specify.

Any special medical conditions _____________________________________________

List any handicaps or special needs________________________________________________

I would like van transportation instead of a subway pass: Yes ______ No ______
Only for people unable to use the subway. There is a charge of $300 per person charge & a minimum number of registrants

Scholarship Contributions If you can possibly contribute to the scholarship fund for 2007, please fill out the following pledge.
I would like to be a (circle one)
 

Seminar prices are based on airfare from New York City. However, we can arrange a connecting flight from your hometown or a direct flight at an additional charge. Please indicate your preference below.

Airline Preference

       1st Choice _________________________

       2nd Choice _________________________

check one

_____	I want only the direct flight from New York City
_____	I want a flight from New York City
	with a connecting flight from  ____________________
_____	I want a direct non-stop flight from  ____________________

  

Please remember that to arrive in Europe on a given day requires leaving the day before from the U.S.

I would like to depart:
      
       on _______________________________
      
       from ______________________________
       date - city (and airport if applicable)

I would like a return flight:
      
       on _______________________________
      
       from ______________________________
       date - city (and airport if applicable)

List any additional flight requirements:
      
      
      

Please make checks payable to French Organ Music Seminar and return this registration form with your $250 non-refundable deposit to:

French Organ Music Seminar, Christina Harmon, Director
8409 Pickwick Lane #123, Dallas, Texas 75225