ONLINE APPLICATION

[] Saturday (10 weeks)

- OR -

[] Tuesdays & Thursdays (14 weeks)

[] $2,795.00 Paid in full (Enclosed)

- OR -

[] $ 495.00 Down payment (Enclosed)

Space is limited, to guarantee your place a $495.00 minimum down payment is required no later than two(2) weeks prior to the first day of class.
Remaining balance due first day of class - credit card or cashiers check required. Personal check accepted if received seven days before first day of class.

Please complete the following to reserve a place in our next class:

[] Personal Check [] Money Order [] Cashiers Check
[] Discover [] Mastercard [] Visa [] American Express
Credit Card Number: Exp.Date:

STUDENT INFORMATION:

Name:
Address:
City:	State: Zip:
Phone:	Work: SSN:

REFUNDS AND CANCELLATIONS

1. A full refund will be made of all deposits or payments if cancellation is made before the start of the first class.
2. After the first class but prior to the second class, all but $250.00 will be refunded if cancellation is made.
3. For cancellations during Class 2 through 5, a prorated refund of the balance will be made. After Class 5, no refunds will be made.
4. Those wishing to cancel for illness or personal reasons may resume their course of study in the next class series with no penalty.

I have read and I understand this agreement.

_________________________________________		February 22, 2012
Student Signature		Date

How did you find out about our course? Newspaper Phone Book Former Student Internet Other

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