Name:
Address
City, State, and Zip Code:
Telephone Number:
(You will be called if a class is cancelled or changed.)
I wish to register for the following classes at Athena (please include the class title, the day, date and time the class is offered, and the fee for each class):
Enclosed is (amount) for listed classes:
VISA/MasterCard/Discover Number:
Expiration Date:
Authorized Signature:
