Advanced Workshops Registration

Date of Application:

(MM/DD/YY) required

Year:

2004 required

Workshops:
Please select the workshops you want to attend.

Session A: October 25-28, 2004
  Select the Workshop Advanced Fabrication-Session A Advanced Security-Session A No Workshop

Session B: November 1-5, 2004
  Select the Workshop Advanced Fabrication-Session B Advanced Security-Session B No Workshop

First Name & MI:

required

Last Name:

required

Address:

required

Addl. Address:

City:

required

State/Province:

required

Zip/Postal Code:

Country:

required

Home Phone:

(XXX-XXX-XXXX) required

Work Phone:

(XXX-XXX-XXXX)

Cellular Number:

(XXX-XXX-XXXX)

E-mail Address:

(you@something.com)

Social Security #:

(XXX-XX-XXXX)

Date of Birth:

(MM/DD/YY) required

Person to Contact
in Case of Emergency:

Relation to Student:

Phone #:

(XXX-XXX-XXXX)

Are There Any Medical Conditions We Should Be Made Aware Of:

Nonerequired

How Did You Hear About Ritop:

Do You Need Housing?

Yes No

Additional Information or Questions:

All applications require a non-refundable $50.00 Administrative Processing Fee.
Tuition fees paid after your application is accepted are refundable per Massachusetts law.

Deposit Payment Information

Payment type for the required deposit:

Personal or Bank Check (Payable to Ritop)

Credit Card:

Credit Card Type MasterCard Visa American Express Discover

Credit Card Number

Expiration Date:
(MM/YY)

We Accept:
MasterCard, Visa, Discover and American Express credit cards and also Personal & Bank Checks.

If paying by check, send deposit payment with a printed copy of this form to:
The Ritop School for Mobile Electronics
Attn: Admissions
200 Dexter Avenue
Watertown, MA 02472

Toll-Free 1-888-44-RITOP
617/923-4043
Fax 617/923-4886

Credit card transactions submitted via this form are not encrypted. If you are concerned about maintaining security of your credit card number, please call toll-free 1-888-44-RITOP or 617/923-4043 with your credit card information, or fax your name, address, credit card number and expiration date to 617/923-4886.

Advanced Workshop Tuition: $1000.00 per workshop, includes all fees, workshop materials and texts.

Scholarships are available. Contact the Director at 1-888-44-RITOP or info@ritop.com.

Housing (if required): $200 per week, double occupancy.
Fees: $50 Administrative fee required with application.
Deposit: $300 Due three weeks prior to workshop start date.

(Pricing is accurate as of 6/15/04--subject to change without notice.)

To apply, you may also download an application in Adobe Acrobat PDF form from our publications page and mail or fax it to us.