CLASS REGISTRATION APPLICATION FORM

Name:
Address:
Email Address:
Phone Number:
Professional Title:
License #
(if applicable):
Class you are interested in:


How did you hear about us?
Briefly, what do you hope to receive from participating in this class?
Have you had any training related to the class? If yes, what and when:
Are there any special accommodations you will need to participate in class?


 

*Note: For classes that have prerequisites, completing this form does not guarantee you a place in class until all prerequisite have been turned in. We want you to have the best possible class experience. Therefore, we have determined that at least 3 but not more than 6 participants must be registered by the Final Registration Deadline or class will be cancelled and refunds will be mailed out. Once the Registration Deadline has passed, there will be no refunds. Once you have been confirmed for a class, we will send you an email with payment instructions via PayPal (you'll need a PayPal account to do this) or personal check in the mail. Payment must be received by the Registration Deadline. If you are unable to attend after being confirmed for a class due to an emergency, we will allow you to reschedule for the same class at a later date.




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