Scentwork Class with Ana Cilursu DROP-IN Payment Form
This form is ONLY for students PRE-approved for drop-in by instructor or registrar.
Name
*
First Name
Last Name
Email
*
example@example.com
Cell Phone Number
*
Please enter a valid phone number.
Name of Dog
*
For Multiple dogs add info in comments
Date and Time of Drop-In Class Session
*
-
Month
-
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 DROP-IN -Member in Good Standing
NW Class DROP-IN with Instructor Ana Cilursu
$
25.00
Quantity
1
2
3
SW Class DROP-IN Non-Member
NW Class DROP-IN with Instructor Ana Cilursu
$
35.00
Quantity
1
2
3
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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