Ikebana in School Booking Form
Shoso Shimbo & Associates
School
*
School Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Person
*
First Name
Last Name
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Workshop Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Starting Time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Finishing Time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Year Level
*
1 - 12
Number of Students
*
Number
More than one group? Give details for other than above.
e.g. 9:50-10:30 Workshop with 20 Year 11 students
Total Number of Workshops
*
Workshop fee (a)
*
Number of workshops @$280, e.g. 2 workshops = $560
Is there any additional students in any group?
*
No
Yes
Answer No, if all groups are 8 or less.
If yes, total number of additional students
Type 2 if your group has 10 students. Type 6 if you have 3 groups of 10 students each.
Fee for additional students (b)
*
$10 each for additional students, e.g. $30 for 3 additional students.
Total (a+b)
*
Fees for workshop + additional students (number of additional students X $10)
Do you require other services?
*
No
Demonstration
Display
If yes, give details.
Is your school more than 100 km from Melbourne CBD? If so, how far?
Transportation cost of $3 per 10 km will be added
Submit
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