For more information:
www.su.edu/conservatory/cmi
Payment
_____________________________________________
Name
Total for tuition
$ ________ (arst)
($525/week)
Materials packet
$ ________ (arst)
($50/one week - $85/both weeks)
On-campus Housing/Meal total
$ ________ (arst)
$20 special application fee*
$ ________ (suapn)
Total
$ _________
Method of payment (please check one):
Check American Express Discover
MasterCard VISA
Money Order
Amount of check or amount to be charged $_______________
(make check/money order payable to Shenandoah University)
___________________________________________________
Card number
Expiration
Cardholder’s address
___________________________________________________
Street
___________________________________________________
City
State
Zip
___________________________________________________
Name as it appears on credit card (please print)
Signature of cardholder (required)
X _________________________________________________
Deadline
The completed CMI registration
and full tuition balance is due:
June 3
2009 CMI Registration
_____________________________________________
Name
____________________________________________
SU ID # or SS#
__________________________________________________
Street
__________________________________________________
City
State
Zip
Do you plan to stay in a university residence hall room?
Yes
No
_____________________________________________
E-mail
____________________________________________
Church
_____________________________________
Daytime phone
_____________________________________
Mobile phone
I am registering for: Week I
Week 2
(check all that apply)
(6/21 – 6/26)
(6/28 – 7/3)
On-campus Housing and Meals
$50 per day
X _______ nights = $ ___________
includes on-campus residence hall accommodations
and three meals.
Please circle the dates below, indicating the evenings you plan
to stay in a residence hall.
Week I:
June
21 22 23 24 25 26
Week 2:
June
28 29 30 1 2