Noyes School of Rhythm Reservation Form



To assure your place and week of choice, please fill in and mail this form (before June 15th*)
with your $50 deposit made payable to Shepherd's Nine

to:

Carol Ribner
1 Toms Point Lane
Apt 2F
Port Washington, NY 11050

We are a non-profit organization and welcome guests of all nationalities irrespective of race, creed, or color.

Name:__________________________________________

Address:__________________________________________

__________________________________________________

Telephone:_______________________ Amount Enclosed: __________

I plan to be at the Noyes School from ____________________ to ____________________.

Please list any additional dates you will be staying _____________________

I would like a single tent ____ (or)

I would like to share a tent with ______________________________.

I will bring my own linen ____ I would like to rent camp linen ____

I have applied for an Onion Scholarship (check for Yes)________

I need transportation from: Middletown bus station ____Meriden train station ____ Bradley Airport ____ Please call ahead to confirm transportation details.

Transportation not available on Wednesdays.

We provide a healthful diet. Do you have any special dietary concerns?____________________________________________
____________________________________________.

*after June 15th mail directly to The Noyes School of Rhythm P.O. Box 70
Portland, CT 06480

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