Mail this form in with your check.  Or this is the one I'll fill out over the phone if you call in with your credit card.

Date:______-______-______

Name____________________________________ 

Address________________________________________________________________________ 

City__________________________________________  State__________   Zip_______________

Home Phone #__________________________ 

email address_______________________________

Cell or work phone where you can be reached during the day__________________________________

Class applied for #1________________________________________  $125.00  

Class applied for #2_________________________________________$125.00  

Confirmation of your registration will be sent to you by email or card after I've received payment.