Instructor Info Form US - O'Flaherty Irish Music Retreat

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Teaching Traditional Irish Music

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U.S. Instructor Info Form

This form is for instructors of the O’Flaherty Irish Music Retreat that are living in the U.S. The information gathered will help us manage matters like your travel, your dietary needs, guests who will accompany you, etc. Thanks for your cooperation in completing this form at your earliest convenience!

Please enter your name as it appears on your driver's license.*
First Last
Name you want published on website and for marketing.
First Last
Social Security Number*
If you are concerned about entering your social security number here, enter all zeros and later call or text Ken Fleming at (214) 770-5036.
Date of Birth (needed for booking travel)*
Month
Day
Year
Email*
Website (if any)
Cell Phone*
Home Phone
Address*
Street Address Address Line 2 City State ZIP Code
Will you be travelling to the retreat by car or plane?*
- By car
- By plane
- Don’t know yet
What will be the probable city/airport from which you will be driving/flying?*
Emergency Name*
First Last
Emergency Phone*
Do you have any food allergies or dietary requirements?*
- None
- Yes
If YES, please describe:*
Will you be accompanied by a spouse, loved one, friend, guest?*
- No
- Yes
- I don’t know yet
If YES, please provide the name(s):*
If YES, will they be attending as a student(s) or non-student(s)?*
- Student(s)
- Non-Student(S)
PLEASE NOTE: Costs for tuition, travel, lodging and meals of any accompanying guests will be borne by the guests or instructor. Relatives of instructors will receive 50% off their tuition.
Would you like a complimentary Retreat T-Shirt?*
- No T-Shirt
- Yes T-Shirt
What size t-shirt would you like?*
Comments:
Regarding instructional aids, audio visual equipment and other items that you will need for your core classes and/or enrichment classes, we will send you a link to an online form prior to the retreat for you to register those needs.
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