Registration for classes

for Journey to Wellness class; $120 for 8-week series
($108 if paid on-line).

We protect your privacy. Personal information will not be sold or shared with any other organization. If you do not wish to be on our mailing list, check here:

* required

*Class starting date: 04/11/12

*First name:

*Last name:

*E-mail address:

*Address:

*City

*Zip

*Phone/home: (xxx-xxx-xxxx)

Phone/work: (optional)

                    Registering only; will pay $120 at first class.
    Payment: On-line by credit card (a secure transaction) $108

(Click on Send to complete the registration process)

Class code: (for office use only)