ODYSSEY WEBINAR STUDENT REGISTRATION WEBINAR INFORMATION Webinar that you are registering for: CONTACT INFORMATION Last Name: First Name: Middle Name: Address: City: State: Zip: Country: Home phone: Cell phone: EDUCATION List the most recent schooling first, and then previous schooling: School (1): Location: Major: From (MO/YR): To (MO/YR): Degree: GPA: School (2): Location: Major: From (MO/YR): To (MO/YR): Degree: GPA: Additional training, workshops, and seminars attended: WRITING HISTORY Publications, awards, and memberships: How many days per month do you write? When you write, how many hours per day do you write? Describe your development as a writer. How would you describe your skills at this point? What would you like to learn from Odyssey's webinars? What are your writing goals? (500 words max) What unpublished works have you written? Title (1): Genre: Length: Title (2): Genre: Length: Title (3): Genre: Length: Title (4): Genre: Length: Title (5): Genre: Length: Please tell us how you learned about Odyssey: TUITION PAYMENT Please note that those paying with a US check or money order, or an international bank draft in US dollars pay the discounted rate of $69. Those paying via PayPal must pay the full rate of $72. Please check one of the following: _______ I will pay my $62 tuition fee via PayPal (see bottom of registration page). _______ I am sending my $59 tuition fee as a US check or money order via regular mail. _______ I am an international student and am sending my $59 registration fee as an international bank draft in US dollars. _______ I will pay my $157 tuition fee via PayPal (see bottom of registration page). _______ I am sending my $150 tuition fee for all three webinars as a US check or money order via regular mail. _______ I am an international student and am sending my $150 registration fee for all three webinars as an international bank draft in US dollars. Terms of Agreement: Class content, in any format, is for the individual student only. Such content includes handouts, readings, assignments, emails, files, resources, and recordings. Class content may not be posted, copied, shared, or distributed. The copyright of class content belongs variously to the instructor, to Jeanne Cavelos, or to the Odyssey Writing Workshops. I certify that the above information is correct and complete to the best of my knowledge. I authorize investigation of all statements contained herein to provide Odyssey with any pertinent information. My signature below indicates my agreement to these terms of agreement. Electronic Signature (Type full name): Date: Email Address: