Deaf Chef Apprentice Workshop Registration Form

* First Name

* Last Name

* Date of Birth:

* Street Address

Address Line 2

* City

* State

* Zip Code

* Phone Number

* Email Address

Please note that this program is offered only to deaf and hard of hearing individuals.
Please provide confirmation that you meet those qualifications.

*

Yes, I am a deaf/hh individual

Participant Information

* Are you a college student?

If yes, which college/university are you enrolled in?

If no, what is your occupation?

* Are you interested in a career in the food industry/culinary arts?

* Deaf Chef Apprentice Program will provide oral/sign support. Please let us know if there are any other special needs that we need to be aware of...

Please tell us how you heard of this program?

What interests you most about Culinary Arts?

Payment Info

The Deaf Chef Apprentice workshop fee of $300 may be paid with credit card, check or money order*. Please enter your credit card information in the secure fields below.

(*If you are paying with check or money order, please send payment to Aspen Camp / PO Box 1494 / Aspen, CO 81612. Payment must be received within one week of submitting this application.)

Name on Card

* Credit Card Type

* Credit Card Number

* CSC Code

* Expiration Date (mm/yy)

* Indicates Response Required


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