Course Registration Form

Please call or email if you have any questions.
Phone: 416-487-1288
Email: bseagram@uniserve.com

Please enroll me for a course of lessons in the following class:

BASIC/ INTERMEDIATE ______(Circle) to commence on __________________ at ______time

I ENCLOSE A CHEQUE IN THE AMOUNT OF $______ TO COVER COST OF COURSE.

NAME: ____________________________________ TEL. NO: ( ) ______________

ADDRESS: ____________________________________ APT. # __________

CITY: _________________ PROVINCE: _____ POSTAL CODE: _________

EMAIL: _______________________________________________________

NOTE: No further confirmation will be mailed to you. Your cancelled cheque is your receipt.  No credit card payments for courses, please.

Please print out this form, complete and mail it directly to:

Barbara Seagram
220 Lawrence Avenue East
Toronto Ontario M4N 1T2
Canada