Full Name*First NameLast NameE-mail*Tuesdays 7:00-8:30pmTuesday, May 17 Tuesday, May 24Tuesday, May 31Tuesday, June 13Tuesday, June 20Will you be attending all of the days?YesNoNumber of Attendees*Number of Attendees*Number of Classes Attending:*1 AttendeeNumber of Classes Attending:*2 AttendeesNumber of Classes Attending:*3 AttendeesNumber of Classes Attending:*4 AttendeesNumber of Classes Attending:*5 AttendeesWhich classes would you like to attend?12:00-1:30pm Tuesday, February 812:00-1:30pm Tuesday, February 1512:00-1:30pm Tuesday, February 2212:00-1:30pm Tuesday, March 112:00-1:30pm Tuesday, March 812:00-1:30pm Tuesday, March 15Which classes would you like to attend?12:00-1:30pm Tuesday, February 812:00-1:30pm Tuesday, February 1512:00-1:30pm Tuesday, February 2212:00-1:30pm Tuesday, March 112:00-1:30pm Tuesday, March 812:00-1:30pm Tuesday, March 15Which classes would you like to attend?12:00-1:30pm Tuesday, February 812:00-1:30pm Tuesday, February 1512:00-1:30pm Tuesday, February 2212:00-1:30pm Tuesday, March 112:00-1:30pm Tuesday, March 812:00-1:30pm Tuesday, March 15Which classes would you like to attend?12:00-1:30pm Tuesday, February 812:00-1:30pm Tuesday, February 1512:00-1:30pm Tuesday, February 2212:00-1:30pm Tuesday, March 112:00-1:30pm Tuesday, March 812:00-1:30pm Tuesday, March 15Which classes would you like to attend?12:00-1:30pm Tuesday, February 812:00-1:30pm Tuesday, February 1512:00-1:30pm Tuesday, February 2212:00-1:30pm Tuesday, March 112:00-1:30pm Tuesday, March 812:00-1:30pm Tuesday, March 15Which classes would you like to attend?Tuesday, May 17Tuesday, May 24Tuesday, May 31Tuesday, June 13Tuesday, June 20Student Textbook:*Please ship to my home.I will pickup at the first class.Total$0.00I would like to pay today: Full amount$0.00 minimum $ PaymentCredit Card I'd like to try the first class at no charge (no payment required at this time) Credit CardVisaMasterCardAmerican ExpressDiscoverCredit Card TypeCredit Card NumberSecurity CodeName on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberExpiration Month2022202320242025202620272028202920302031Expiration YearBilling AddressStreet AddressStreet Address Line 2CityState / ProvincePostal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOtherCountrySubmitShould be Empty: This page uses TLS encryption to keep your data secure.