IGI Secure Checkout

ALEXANDRIA GUITAR FESTIVAL
Mail-in Registration

Participant Registration Information:

1. First Name:

2. Last Name:

3. Mailing Address:

4. City:

5. State:

6. Zip code:

7. Parent/Guardian's Name:

(For participants under 18 only)

8. How did you hear about us?:

9. E-mail:

10. Re-type E-mail:

11. Telephone:

12. Emergency Contact Name:

13. Emergency Contact Phone:

14. Teacher's Name:

15. Primary Interest:

16. Repertoire:

17. Teacher Preference 1:

18. Teacher Preference 2:

19. Teacher Preference 3:

20. Every Child Can!:

$120.00

21. Suzuki Student:

$320.00

22. Suzuki Teacher Trainer:

$620.00

23. CAMC Student:

$355.00

24. CAMC Auditor:

$155.00

25. Day Pass, Wednesday:

$55.00

26. Day Pass, Thursday:

$55.00

27. Day Pass, Friday:

$55.00

28. Day Pass, Saturday:

$55.00

29. Donation:

30. Total Payment:

*Please make checks payable to: International Guitar Institute

We accept personal checks and money orders

Credit payment is also possible, please provide that information below.

31. TERMS OF AGREEMENT

32. I AGREE TO THE TERMS LISTED
*Registrations will not be processed unless you have agreed to thees terms

33. Date:

34. Special requests and/or comments:

Please print this registration page and mail it to:

ATTN: Registration
The International Guitar Institute
5036 S Rainbow Blvd, Unit 202
Las Vegas, NV 89118

To pay by credit, please provide the following information:

35. Total from line 30:
36. Credit Card Number:
37. Expiration Date:
38. CSC (3 digit number on back of card:
39. Invoice Number or SKU:
40. Name (first and last):
41. Billing Address:
42. Address Continued:
43. City:
44. State:
45. Zip:
46. Country:
47. Billing Phone Number: