Scentwork Class with Ana Cilursu Payment Form
This form is ONLY for students currently training with Ana at SICDTC. No refunds after session start date. For multiple dogs add information in comment section
Name
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First Name
Last Name
Email
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example@example.com
Cell Phone Number
*
Please enter a valid phone number.
Name of Dog
*
For Multiple dogs add info in comments
Start Date of Class Session
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Month
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Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Comments or Additional class/Multiple dog information
Scentwork Classes: Choose ONE option: (If you have club vouchers please ask Desma for coupon code: SICDTC@hotmail.com) You may pay for more than one dog but please add additional information in the comments
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SW Class TC ONLY Discount
NW Class 8 weeks with Instructor Ana Cilursu This is for those who qualify SICDTC Training Committee discount.
$
145.00
Quantity
1
2
3
Item subtotal:
$
0.00
SW Class Member in Good Standing
NW Class 8 weeks with Instructor Ana Cilursu
$
165.00
Quantity
1
2
3
SW Class Non-Member
NW Class 8 weeks with Instructor Ana Cilursu
$
250.00
Quantity
1
2
3
Payment Methods
Debit or Credit Card
Please click one of the PayPal options to complete payment and
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the form.
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