What? Me Worry? Registration Form

Name

First

Last

PayPal Name Commerce

Email

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Comments/Questions

Cost of 5-week course

Price: $40.00

Negotiable in case of financial hardship - to inquire please email natalies@hamiltonjfs.ca

PayPal Commerce

Card Number

Expiration Date

Security Code

Card Holder Name