Thank you for using the 2008 On-line Teacher Application. Please use a separate application for each person. The form must be completed entirely. Required fields are indicated with a *. If you have any questions, call or email the CSI office before submitting your form.

(303) 399-5764. FAX: (303) 399-2999

email:

Teacher’s Personal Information

* Session (you must select a session to see the workshops)
1 2 Both

Name as it will appear on your name badge:
* First
* Last

* Instrument

* Intended Class Status: Suzuki Teacher Training:
Participant Auditor Student Observer

Session 1: Monday, June 9 - Saturday, June 14
Session 2: Monday, June 16 - Saturday, June 21
If course hours total 30 hours or more, there's a 10%
reduction in tuition fees!

Teacher/Parent Enrichment
select multiple enrichments. Select first enrichment,
press and hold ctrl (PC) or command (MAC) key
while selecting other enrichments

Select all years you have attended CSI:
94 95 96 97 98 99 00 01 02 03 04 05 06 07 08

Contact Information

* Address
* City
* State (2 letter abbreviation, ex: CO)
Postal Code
* Country
* Email Address
* Evening Phone
* Daytime Phone

* Deposit paid in '07 for - Session
None 1 2 Both

Previous Suzuki Training: (list units, dates, and instructor, Institutes or workshops attended, other training)

From what source did you learn of the CSI

A current SAA membership is required by the beginning of course.

Observer of Student Classes: (Indicate days you will observe - select all that apply with CTRL (PC) or Command (Mac) keys)

Session 1:

Session 2:

Tape Information

Roommate matching assistance requested
Additional Notes:

T-Shirts (indicate quantity desired)

Size	Quantity	Costs	Total
Youth Small		@ $20
Youth Medium		@ $20
Youth Large		@ $20
Adult Small		@ $25
Adult Medium		@ $25
Adult Large		@ $25
Adult XL		@ $25
Adult XXL		@ $28
TOTAL

For each of your students who attend the 2008 Colorado Suzuki Institute and pay in full, your SAA teacher workshop tuition will be refunded 10% after Institute is over. Have 10 students attend and your SAA course tuition will be refunded in full!

Summary of payment

Item	$	$
Workshop	Varies
Enrichments	Varies
deduction for 30 hours or more	-10%
Observer fee	$100/day or $400/Session
T-Shirt Total
Scholarship fund donation (tax deductible)
Less deposit paid in '07	-
Subtotal
Late Fee: Feb 10 - March 30 - $25 April 1 - April 31 - $50 May 1 - May 31 - $100 after June 1 - $150	$0/$25/$50/$100/$150
Change of session Fee:	$0/$25
Total due with application

Directions to complete registration:

1. We recommend that you print this page for your records before submitting it to us.

2. Once you have submitted the application, a confirmation form will appear that totals your balance due. Print the summary of payment page for your records. We will email to you shortly an invoice along with directions to pay it online using a Visa or MasterCard charge card. If you prefer to pay by check, you can print the invoice and mail it to us along with a check.

3. After we receive your payment, we will email to you a musical confirmation number within 3 working days. You need this musical confirmation number to make lodging reservations at our reduced ‘Suzuki’ rates.

RELEASE FOR PROGRAM, ACTIVITIES AND EMERGENCY CARE

This statement is to be accepted by all adult participants and by the parent or guardian of student participants under the age of 18.

I hereby grant permission for my child to participate in the program offered by the Colorado Institute of Music and the Colorado Suzuki Institute and Chamber Music of the Rockies (hereafter collectively the “Institute”) and to participate in the extra daily activities and free clinics offered by the Institute. The Institute will use reasonable precaution for the participant’s safety. However, by the very nature of the activities and clinics offered, I understand that the Institute cannot guarantee the safety of every student.

On behalf of myself and my family, I understand, state and agree to hold the Institute, its officers, directors, employees and all those acting on behalf of the Institute, harmless from all liability of any kind by reason of any accident, injury or damage, whether to person or property, resulting from my, my family’s or the student’s participation in the Institute’s 2008 program, activities and clinics.

Any controversy, claim or alleged liability arising out of or relating to this agreement, or my, my family, or the student’s participation in the Institute’s 2008 program, shall be settled by arbitration administered by the American Arbitration Association, in Denver, Colorado and judgment on the award rendered by the arbitrator(s) may be entered in any court having jurisdiction thereof. Each party shall pay its own costs and attorney fees.

I hereby grant permission for the Director of Music, or the Director’s authorized personnel, of the Colorado Institute of Music, Inc. to obtain medical care on behalf of my child, the above named students, in the event of an emergency. I understand and agree that such action may include, but not be limited to:
a) Contacting a physician or paramedic;
b) Admitting the student to an emergency clinic or hospital;
c) Engaging the services of ambulance or other emergency vehicle.

I understand and agree that such action will be taken on behalf of the student and that I, as the student’s parent or legal guardian, shall be responsible for all costs and expenses of such emergency treatment.

It is possible that photographs of institute participants may be taken by the news media or by a staff photographer. By accepting the release of liability form you are giving permission for the Colorado Institute of Music to use your image/photograph in any official publication or presentation relating to the promotion of music education. This includes, but is not limited to, multimedia productions such as television, video, web sites, brochures, etc. and you release all rights to the aforementioned photograph/image. You also understand that you will not be compensated monetarily or in any other manner for the use of the image.

Name of Head of Household or Legal Guardian who is granting permission *

Errors detected in the application