Online Application Form

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Please fill out the form below to complete your enrollment. Thanks!

*PAYPAL Receipt No:

*NAME:

*EMAIL:

ADDRESS:

ADDRESS 2:

CITY:

STATE: ZIP:

PHONE:

IN CASE OF EMERGENCY CONTACT:

NAME:

ADDRESS:

ADDRESS 2:

CITY:

STATE: ZIP:

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You will receive confirmation of your enrollment within two weeks of receipt of application. If you do not receive confirmation, please call 773-477-6482.

Please explain why you are taking this class and what you hope learn.