Tuscan Workshops  P.O. Box 602 Rockville Centre, NY 11571-0602 917-747-3873 Email: TuscanWorkshop@aol.com

Application for Enrollment Early enrollment is highly advised as this program fills quickly. Please fill out this form carefully and return it to Tuscan Workshops, P.O. Box 602, Rockville Centre, NY 11571-0602. Please make check payable to TUSCANY 2000. Your deposit of $500.00 in U.S. currency will insure a place in the program. Deposit is per person, double occupancy. There is a single supplement fee of $300.00. These rooms are limited and will be available on a first-come, first-served basis. Please read the disclaimer at the bottom of this enrollment application before signing. PLEASE KEEP A COPY OF THIS FORM FOR YOUR RECORDS. Name: ___________________________________________________________________________ Address: ___________________________________________________________________________ City: ___________________________________________________________________________ State: ______________________ Zip ______________________ Home Telephone: ______________________ Business Telephone ______________________ E-mail: ___________________________________________________________________________ I am interested in the workshop for Painting/Pilates/Photography (please circle) - June 29 - July 6, 2013   Please state level of advancement ____________________________________________________ Do you have any special needs? (Prefer ground floor room, have limited walking capacity, etc.) Please note that our excursion days involve a considerable amount of walking ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I will be traveling with a companion _____________ (please fill out a separate application) The price of all land arrangements: Painting/Pilates/Photography workshops week - $2900 Non-workshop guest - $2500 Applications will be processed in order of their receipt. A $500.00 deposit is required to process your application. Final payment is due by May 15, 2013. All fees paid are refundable in the event of participant's cancellation 30 days prior to departure less $150,00. The program price includes all of the itemized services described in the full color brochure. No refunds will be made for any part of the trip that is offered and not participated in. No refunds will be made for anyone who does not attend the workshop and has not applied for a refund 30 days before departure date, No refunds will be made for any missed meals or missed day trips. If the workshop is cancelled by the company within 30 days of departure, applicants will receive a full refund of all monies paid. You must be at the Rome airport on the morning of June 29th at 9:30 AM. Please plan your itinerary accordingly. Exact location of meeting place is at the International Arrivals Building, (where the plane leaves you) Terminal "C", ground level at the information desk. No refund will be made for anyone who chooses not to use coach transfer offered in either direction. On the morning of departure our coach will leave the villa at 6:45 AM in order to arrive in Rome at 10AM. Please schedule your flight accordingly. You are requested to inform us of your exact flight arrival time prior to departure to insure proper coincidence at Rome airport. Please sign and date: ___________________________________________________________________