Obedience Monday Class Payment Form
This form is ONLY to be used by those students currently taking classes with Regina at SICDTC or have been pre-approved by the registrar
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Include Start Date of Session & Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Dog's Name (for Multiple dogs add information in comments below)
*
Comments or If more than one dog add here
Obedience Classes: If you have club vouchers please contact Desma (sicdtc@hotmail.com) to get a coupon code
*
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Monday Obedience Class Non-Member
8 week classes with instructor Regina Steiner
$
215.00
Quantity
1
2
3
Item subtotal:
$
0.00
Monday Obedience Class Member in Good Standing
8 week class with Instructor Regina Steiner
$
145.00
Quantity
1
2
3
Item subtotal:
$
0.00
Monday Obedience Class Member TC Discount ONLY
8 week class with Instructor Regina Steiner
$
125.00
Quantity
1
2
3
Item subtotal:
$
0.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
Should be Empty: