Wufoo
Community Programs Registration Form
Quickly register here or
download our PDF form
to send via fax or email.
Questions? Call 510 647-2974 or email
outreach@berkeleyrep.org
*Required fields
1
Contact Info
2
School Info
3
Scheduling Info
4
Workshop Info
Main Contact Name
*
First
Last
Main Contact Phone Number (work or personal)
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###
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Main Contact Email
*
By providing my email, I'm signing up to receive online correspondence from Berkeley Repertory Theatre. I can unsubscribe anytime or tailor my personal account to receive the type of information I want after signing up.
If you wish only to receive emails related to your registered program, please check here.
Preferred method of contact:
Phone
Email
Either
Best time to reach you
Teacher Name (if different from Main Contact)
First
Last
Have you booked a workshop with us before?
Yes, I've booked workshops in the past.
No, this is my first workshop with Berkeley Rep.
How did you hear about us?
Select
Received email from School of Theatre
Received poster in the mail
Referral from another teacher
Referral from a District Administrator
Berkeley Rep website
Taken class or seen show at Berkeley Rep
Online listing
Other
1
/
4
Do Not Fill This Out