Eagle Hill Masthead

Application for Seminars

For a printer friendly application form, click here.

* Required fields

*Full Name
*Phone (day)
Phone (eve)
Phone (cell)
*Zip/Postal Code
Age (helpful when assigning rooms)
*Gender Female  Male 
*Alumnus Institute alumnus(a)  1st time applicant 

I would like to participate in the following seminar(s):
*First title
Second title
Alternate title

What are your specific interests, goals and expectations for the above seminar(s)?

Which of your experiences, classes, or interests are related to the above seminars? What is your current career or career interest and institutional affiliation?

Residential preference, if possible.
Classroom building
Student cabin
Tent platform

Do you have personal habits, preferences, or concerns that you would like us to be aware of?

Do you smoke or snore? Smoke Snore

Do you have dietary restrictions and/or allergies we should be aware of?

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%)

If you are a student, please list your university or college. If you are an alumnus, please list seminars you have attended.

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? 

Continuing education units (CEUs) are available for most seminars. Application forms are available upon arrival. There is a fee.
Would you like to earn CEUs?  Yes   No

Are you interested in possibly carpooling if someone inquires? Yes   No
Would you be a driver or passenger?

Other pertinent information, comments, questions, etc., are welcome.

In case of emergency, contact:
Emergency contact name
Emergency contact phone
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 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.

Once you click "Submit" below, you have the option to go to a secure server to pay your deposit by credit card by way of PayPal or to choose "Pay by check".

I will pay my deposit online.
I will pay my deposit by check.
I am e-mailing a pdf of my purchase order or training authorization form in lieu of the deposit.

Notes about payments.

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.

How did you first hear about the Eagle Hill Institute?

How do you like to keep informed about Eagle Hill?
Mailing list emails

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. Full details on liability are available.

E-Commerce site required information ... Contact information - Eagle Hill Institute, PO Box 9, Steuben, ME 04680-0009. Customer service: 207-546-2821 Ext 1, or office@eaglehill.us.Refund policy: See ... http://www.eaglehill.us/programs/general/application-info.shtml. Privacy statement: We know that you care how information from you is used. We do not share your information with others.

Site by Bennett Web & Design Co.