Registration Form

Irish Language and Culture Weekend
October 12-14, 2007
Madison, Wisconsin

Please print this form on paper in order to complete it. If you cannot print from your computer, you may submit the same information by hand.

Name:

Address:

Work phone:

Home phone:

E-mail:

Lodging (see "Cost / Accommodations"):

____ I am planning to stay at the Lowell Center, and have contacted them for room reservations.

____ I will be staying elsewhere during the weekend.

Please indicate your level of Irish by circling one of the following:

• Complete Beginner: have no idea what I am getting myself into.
• Have studied a little bit on my own or have attended other workshops.
• Have taken formal classes before, but I am a bit rusty.
• I know quite a bit of grammar, but my conversation skills are weak.
• Could carry on a conversation about the weather, my favorite pastimes, where I live, what I do.
• Feel pretty confident, as long as the other person doesn't speak too quickly.
• Líofa

To register for the weekend, please mail the completed registration form along with payment in full to guarantee your reservation to attend the program. Payment is due by Oct. 1, 2007. Checks should be made payable to the Celtic Cultural Center of Madison and mailed to: Celtic Cultural Center, PO Box 6646, Monona WI 53716. Sorry, there are no refunds available after Sept. 30, 2006.