Registration: Fall 2010 Retreat for Academics

November 11 – 14, 2010
The Garrison Institute
Garrison, NY
Learn more about this retreat

How To Register:

Complete and submit the registration form below. You will then be forwarded to a payment options page. Your registration will not be completed until payment is received.

If you are applying for financial assistance, please provide a brief description of need on the application and we will contact you with payment instructions; you do not need to pay at this time.

Cancellation Policy:

Before September 15th: Full refund, less 10% processing fee.
After September 15th: Regrettably, due to contractual obligations with the retreat center, we will be unable to provide refunds on cancellations made after this date.

Registration Form
Name:
University:
Department:
Mailing Address:
City:
State:
Zip:
Is this a work or home address?	work home
Email:
Phone:
Is this a work or home phone number?	work home
Cell:
How did you hear about this retreat?
Please check this box to indicate that you understand our cancellation policy:
Are you an ACMHE member?	yes no
	If yes, you may skip the next two questions.
Please summarize your contemplative practice experience:
How do you integrate (or plan to integrate) contemplative practices into your classroom?
Please indicate here if you would like to apply for financial assistance and provide a brief statement of need:
Accommodations:
Gender:
Preferred Roommate:
Health/other needs:
Dietary Restrictions:
Is there any additional information we should know?
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