Community ASL Class Registration
Classes will be September 24- November 12, 2019
Please fill the form out entirely. The asterisk (*) indicates that the information for that section is required. If that section does not apply to you, please type N/A. If you have any questions or concerns, please feel free to contact me.
**Submitting this form electronically will not secure your registration. Registration will be secured once payment is received.**
Please make checks or money orders payable to E.H. Gentry. Please do not sent cash in the mail. Also, there will be a $35 charge for un-honored checks.
Space is limited! Please register now!
**Must have 5 people preregistered per class prior to the first day of class to secure the class.**
Contact Information: or 256-761-3492 or 256-375-5577
Please send payment (and/or registration) to:
EH Gentry- Deaf Services- Sara Milam
PO Box 698
Talladega, Al 35161
Email address *
Name: *
Your answer
Mailing Address: *
Your answer
Email: *
Your answer
Phone Number: *
Your answer
Is your phone text capable? *
Accommodations Required:
Your answer
ASL Class Option *
Child in AIDB program? *
Child's Name:
Your answer
If yes, which program/campus
How do you intend to pay: ($70 by September 23, $75 September 24 and after) *
Your answer
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