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Tus . Nov 8 - Dec 13

Contact
Full Name*

First Name Last Name
Phone Number*

Area Code Phone Number
E-mail*
Session 2 begins Tues. Jan 17
Jan 17 - Feb 21 $10 suggested per class

Tue Jan 17 Tue Jan 24 Tue Jan 31 Tue Feb 7 Tue Feb 14 - cancelled Tue Feb 21 Tue Feb 28
Session 3 begins Tues. May 16
May 16 - June 13 $10 suggested per class

Tue May 16 Tue May 23 Tue May 30 Tue June 6 Tue June 13
Donation for Class Series

Suggested $10 donation per class
Donation Optional

$10 $20 $30 $40 $50 $75 $100
Total

$0.00
Payment

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

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Street Address

Street Address Line 2

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