The Stanford Professional Publishing Course

July 2008 · Stanford, CA

To apply, please fill out the form below. Press the "SUBMIT APPLICATION" button when you are finished. An online Registration Confirmation notice will follow, explaining logistics, invoicing and other particulars. If you have any problems with this application form, contact Program Coodinator Melissa Vallejo at mvallejo@stanford.edu or 650-725-4301; she will be happy to assist you.

I. Participant Information

SALUTATION	Mr. Ms. Dr.
FIRST NAME
LAST NAME
HOME ADDRESS



CITY
STATE
ZIP/POSTAL CODE
COUNTRY
HOME PHONE
HOME FAX
HOME E-MAIL
AGE
GENDER	Male Female
CITZENSHIP

II. Professional History
CURRENT TITLE/ POSITION
COMPANY/ ORGANIZATION
COMPANY ADDRESS



CITY
STATE
ZIP/POSTAL CODE
COUNTRY
COMPANY PHONE
COMPANY FAX
COMPANY WEBSITE
COMPANY E-MAIL
E-MAIL PREFERENCES	To which address would you like your mail sent? Home Office
	Would you like to be notified via email about other Stanford course offerings for publishers? Please note that our Virtual Seminars are announced only via email. (We never share your email address with anyone.) Yes, please send e-mail notices
ORGANIZATION'S MAIN ACTIVITIES
NUMBER OF EMPLOYEES
CIRCULATION (if applicable)
NUMBER OF YEARS YOU'VE WORKED IN PUBLISHING

III. Track Choices

PLEASE INDICATE YOUR CHOICES BELOW:
	I am applying for the Main Course (July 12-19, 2008) in the following track.
		Book track
		Magazine track

	I am also applying for the International Pre-Course (July 10-12, 2008).
		Yes
		No

IV. Tuition & Discounts
Tuition for the Main Course is $4,350 Tuition for the Pre-Course is an additional $1,425 A discount of 10% will automatically be applied to your total tuition if your application is postmarked on or before April 15, 2008 A discount of 10% will be applied to your total tuition if two or more people from your organization apply together A discount of 10% will be applied to your total tuition if you are an alumnus of any of the following Stanford Publishing Courses: Publishing on the Web, Strategic Planning Course for Publishing Executives, Stanford Video on the Web Workshop, or Stanford Publishers Travel-Study Tour of China.) Discounts may be combined to a maximum of 30%.
PLEASE INDICATE YOUR DISCOUNT ELIGIBILITY BELOW:

	I am applying for a group discount.
		Yes
		No
	If 'Yes', enter name(s) of other group members below. NOTE: Your application will be processed once applications from all members of your group have been received.

	I am applying for an alumni discount.
		Yes
		No
	If 'Yes', enter name and year of the eligible course which you attended (Publishing on the Web, Strategic Planning Course for Publishing Executives, Stanford Video on the Web Workshop, or Stanford Publishers Travel-Study Tour of China):
V. Housing/Meals

PLEASE INDICATE YOUR CHOICES BELOW:
		Housing for main course only (arrive July 12, depart July 20) at $664.

		Housing for international pre-course and main course (arrive July 9, depart July 20) at $913.

		No housing needed

PLEASE INDICATE ANY DIETARY RESTRICTIONS:
		None
		Vegetarian
		Allergic to (please specify):

VI. Summary Biography Please submit a short (6-8 sentences) biography introducing yourself on both a professional and personal level. Use the sample below as a guideline. Be sure to include the following information: your name, current title, company, company location, current duties, prior positions at other publishing firms, and any outside interests or hobbies you'd like others to know about. Should you be accepted to the course, this bio (or a shortened version of it) will be included in the binder given to all participants. For that reason, we ask that you do not simply paste in your current resume. SAMPLE: Pat Jones is editor-in-chief of SportsLife magazine in New York City. SportsLife is aimed at avid sports fans around the world (circulation 300,000), and Pat has the enviable task of deciding which sports to highlight in each issue. Prior to joining the SportsLife team, Pat was associate editor at Women's Runner and assistant editor at Golf magazine. She's a marathon runner who lives in Manhattan with her two large Irish wolfhounds. YOUR BIOGRAPHY (maximum 300 characters):

VII. Form Submission OUR CANCELLATION POLICY Full refunds (less a $200 application fee) will be given for confirmed registrations cancelled in writing by June 15, 2008. After that date, you will not receive a refund, but you may defer your participation until the following year (any tuition increase will apply) or send a qualified substitute in your place (application form required).



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