Mind Sharpener Winter/Spring 2023 Registration Form

Mind Sharpener Winter/Spring 2023 Registration Form

January 3rd, 2023 - March 23rd, 2023 from 2:45 PM-4:00 PM

Tuesdays & Thursdays
- Each participant must be screened prior to the class to make sure your cognitive level is appropriate for the program. A JFS representative will contact you.
- Members from the same household should each register separately.
- Ideally, each participant will be viewing the class on their own device.
- The program includes 24 one-hour sessions.
- Classes meet on Tuesdays and Thursdays from 2:45pm-4pm.
- Classes begin on January 3rd, 2023 and run through March 23rd, 2023.
- Class size is limited; a waitlist will be created if needed.
Name*

First NameLast Name
Phone Number*
Format: (000) 000-0000.
Email address where we will send your exclusive link for the classes*

Mind Aerobics 24-class series (per person)

You are registering for 24, 1-hour Mind Aerobics classes.

$180.00 Quantity

Scholarship Assistance Needed

A JFS representative will contact you.

$ Free

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

A separate registration will need to be completed for each participant.

If you prefer to pay by check, fill-in the above registration information, then print and mail form along with payment to:

JFS of Washtenaw County
2245 S State St
Ann Arbor, MI 48104
Any questions or comments?
Should be Empty: