Explorations in Afro-Cuban Dance and Drum

Online Registration Form

 

Registrations will be accepted on a first come/first served basis. SPACE IS LIMITED!


NOTE: Only VISA, MasterCard and Discover registration payments are accepted via this form.

If you are paying with a CHECK: Do not use this form. Please use the downloadable form [PDF].


If you do not wish to use this on-line registration form, or if you are having trouble with it,
please use the downloadable form [PDF]. Fill out the form and mail it to the address below.

 

Or call (707) 826-3731 to register (Open Mon.-Fri., 8 a.m.-5 p.m. PST) VISA-MC-Discover


Mail the PDF registration form with your check or credit card information to:

Afro-Cuban Dance and Drum
College of eLearning & Extended Education
Humboldt State University
1 Harpst Street
Arcata, CA 95521-8299

 



STUDENT INFORMATION

  

Country*          
Enter your date of birth:*         *       
YES          NO


ESTIMATED SKILL LEVEL

Check the most appropriate level.
 DANCE:
 DRUM:

 

WORKSHOP FEES

     

Registrations received after July 5: $550

 


$     

  Full week fee includes admission to the pre-program activities and all available dance,
     drum and song classes offered each day, and the evening events.



   
  
  Attend only FIVE workshops and/or lectures of your choice.

   

 


$     

 

    $120/day
Check day(s) attending:

 

 

 

$



Check day(s) attending:

 

 

 

$
$

   
  Optional. Drum rental priority is given to full-week participants.

 

 

$


SOUVENIR SHIRT OPTIONS

If you are interested in purchasing a souvenir shirt should they become available, indicate the quantity desired of each style and size here. Shirts may be available for purchase during the program.

  T-SHIRTS: S:    M:    L:    XL:    XXL:    XXXL:
  LONG-SLEEVED SHIRTS: S:    M:    L:    XL:    XXL:    XXXL:
  TANK-TOPS: S:    M:    L:    XL:    XXL:    XXXL:
 

ACADEMIC CREDIT (Optional)

Participants who attend all workshop classes, all days, may earn up up to 3 UNITS at $50 add'l fee per unit ($23 per half-unit).

Enter number of units next to the course credit option.
(Enter up to 3 units in any combination):








DANC 480


 
 

To receive academic credit, you must provide the FOLLOWING:

All sensitive information is submitted via SECURE SERVER, and is requested pursuant to Section 41201, Title 5, Calif. Code
of Regulation and Section 6109 of the Internal Revenue Code.
  More information (opens new window)
  -   -

additional student information

Please answer the following (* = required):

:*
YES     NO

 

Select your gender: *
Male    Female


Have you previously attended Humboldt State University?
YES     NO

 


RACE/ETHNICITY INFORMATION

Your voluntary response is requested to comply with Federal and State legislation.

If the California State University system is asked to report only ONE summary race/ethnicity description for you, choose the ONE category below that you want us to report:

Two or more races/ethnicities

Decline to state

CAMPUS HOUSING OPTIONS

Optional on-campus housing in the Cypress residence hall is available for an additional fee for the entire week, single occupancy (when available) or double occupancy. You may request a specific person as a roommate.

Rates for the entire week include three meals per day (except brunch and dinner only on Sunday). You may also select lodging for early arrival (Fri., July 19) and/or late departure (Mon., July 29).
Details about the campus housing facilities are available at the Conferences Services website.

SINGLE OCCUPANCY

DOUBLE OCCUPANCY*

FEE

Single, July 20-28: $536

(31260)
Double*, July 20-28: $480

(31259)
$
$
Single, early arrival, July 19: $67 (31262) Double*, early arrival, July 19: $60 (31261) $
$
Single, late departure, July 29: $67 (31264) Double*, late departure, July 29: $60 (31263) $
$

* For Double Occupancy: Indicate your roommate preference (optional):

First name:    Last name:

Gender of roommate named above: Male    Female

 

Additional housing comments (optional):

 

TOTAL REGISTRATION COST

$



Please review the above information for accuracy
before submitting this registration form.

       RESET FORM