Request to Join a Class

Here you can submit a request to join a class. Your name will be put on a waiting list. We will contact you via e-mail to complete the registration process. Cost of the course is $100, payable by Interact Etransfer or Paypal.
Your first and last name *
Your answer
Your preferred name
Your answer
Your e-mail *
Your answer
Date of birth (month and year only) *
Your answer
Enter coupon code here
Your answer
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