Please complete and return the following form, along with your payment and signed waiver (see our "Terms and Policies" page), when registering for all Danny Burk Photography, LLC events. No application can be accepted without submitting all of these items in full.


Workshop title/location ________________________________________________________

Date(s) ____________________________________________________________________

Event fee or deposit  $_________________________________________________________

Total cost of event  $___________________________________________________________

Method of payment enclosed ____________________________________________________

Participant name _____________________________________________________________

Address ____________________________________________________________________


Phone (daytime) ____________________________  (evening) __________________________

Cell phone (if available) _________________________________________________________

Emergency phone number (which will be answered while you are away) _____________________

Email address ________________________________________________________________

Health considerations or problems of which we should be aware ___________________________

Special dietary needs ___________________________________________________________

Do you need driving directions?  _______________   Lodging assistance? __________________

How did you learn about DBP workshops? ___________________________________________

Have you taken other workshops in the past? (which ones?) ______________________________

Help us to provide the best assistance by telling us a few things about your photographic
experience and desires by indicating your areas of major interest:

Basic skills_____________    Advanced skills_______________    Composition_____________

Metering____________________     Macro_________________    Panorama _______________

Landscape______________      Other__________________  Black and White_______________

Medium format_______________     Large format__________________

Scanning/printing/Photoshop techniques _____________________________________________

What film will you use during the workshop? (indicate if digital rather than film) ________________

What type of camera (brand and format) will you use?___________________________________

What do you consider your strongest and weakest areas?________________________________

Do you consider yourself:  beginner ____  intermediate ____  advanced ____ professional ______

Special requests that you'd like  to be considered? _____________________________________

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