Missed Lesson Podcast Order Form
Students Name *
Your answer
Class Location *
Your answer
Date of Lesson missed *
MM
/
DD
/
YYYY
Contact Number
Your answer
Email address where you would like podcast sent
Your answer
Credit Card Billing Address
Your answer
Town
Your answer
State
Your answer
Zip
Your answer
Credit card type:
Credit Card Number:
XXXX-XXXX-XXXX-XXXX
Your answer
Name on the Card:
Your answer
Expiration Date:
Your answer
CVV Code
Your answer
Guarantees and Conditions:
Please read the following paragraph carefully. You must check the I Agree box or your order will not be considered valid. I understand and agree to the $8 fee per lesson podcast. I understand the $8 fee is non-refundable.
By clicking I Agree box, I accept and agree to all the terms and conditions as outlined above. *
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