Seminar Registration

an online service of the Nippon Karate-do/Kobudo Seishin-Kan

Please select from the items listed below this form to register for Shimabukuro Masayuki Hanshi's July 17-18, 2009 Seminar at Indiana Wesleyan University

NOTE:  This registration will be processed through Paypal, allowing you to pay by transfer, credit card, or e-check.  The registrant's name will be requested during the PayPal check-out process, so if you are registering for someone else, please remember to indicate the actual seminar registrant's name, postal address, and email address during check-out to ensure they receive all registration information and seminar updates.

Please select ONE of the following Seminar options:

2-Day Complete Seminar Package ($200 Early-Bird Price) 
Package includes both seminar days, Friday nigh banquet, cafeteria lunches both days, and cafeteria breakfast on Saturday morning

Name of Registrant

Banquet Entree

NY Steak au Poivre Broiled Salmon Chicken Cordon Bleu Vegetarian Lasagna

1-Day Seminar with Banquet  ($130 Early-Bird Price) 
Includes one day seminar with cafeteria lunch and Friday night banquet

Day Attending

Friday, July 17th Saturday, July 18th

Name of Registrant

Banquet Entree

NY Steak au Poivre Broiled Salmon Chicken Cordon Bleu Vegetarian Lasagna

1-Day Seminar-ONLY Registration  ($105 Early-Bird Price)
Package includes one day seminar with cafeteria lunch only

Day Attending

Friday, July 17 Saturday, July 18

Name of Registrant

Add any of the following optional items to your seminar selection above:

Cafeteria Breakfasts (optional) $6.00 each 

Number of Breakfasts

1 (either day) $6.00 2 (Friday & Saturday) $12.00

Cafeteria Dinners (optional) $10.00 each 

Number of Dinners

1 $10.00 2 $20.00 3 $30.00

Residence Hall Lodging (optional) $40.00 per night 

Number of Nights Lodging

1 $40.00 2 $80.00 3 $120.00

Which Nights?

Thursday Night Only Friday Night Only Saturday Night Only Thu & Fri Nights (2) Fri & Sat Nights (2) Thu, Fri, and Sat Nights (3)

Bokken Rental or Purchase

Selection

Bokken Rental $20.00 Bokken Purchase $30.00

Tanjo Rental or Purchase

Selection

Tanjo Rental $15.00 Tanjo Purchase $25.00

Airport Shuttle Transportation (optional)
Shuttle to IWU will depart Indianapolis airport at 5:00 PM Thursday, June 16, arriving at IWU around 7:00 PM
Shuttle to airport will depart IWU campus at 5:30 PM Saturday, June 18, arriving at airport around 7:30 PM

Selection

From airport to IWU only (THU) $40.00 From IWU to airport only (SAT) $40.00 Round Trip (THU & SAT) $80.00

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Leonard J. Pellman