Student Rep Application

For students wishing to apply for the Student Rep Program from X-POLE

RETREAT DETAILS - Questioner

About You

Name

First Last

Phone

Email

Address

Retreat Plan

Date

Total Duration

Studio Name

Studio Location

Types of Classes

Expected Number of Attendees

Detailed Itinerary (please attach a rough outline)

Max. file size: 5 MB.

Staff Available for Loading/Unloading?

YES

NO

Parking Facilities Available?

YES

NO

Additional Details

Estimated Participant Fees

Any other key requirements or considerations