REGISTRATION      


You may use this form to reserve a spot in the class, however, you must contact the Community LINK to pay your registration fees or determine your eligibility for a sliding scale.

Please provide the following contact information:

Name
Title
CLASS  Number
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

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Revised: January 17, 2005