Class Registration

Learn more about our AED Program and how to request an AED for your organization.

Playworks Pre-K Tour, October 24, 2012

Please fill out the following form to register for classes online. You may also register for classes by printing and mailing in the offline form.

Class: *

Please select the class you'd like to register for.

First Name: *

Last Name: *

Email Address: *

Home Phone: *

Format: xxx-xxx-xxxx

Work Phone:

Format: xxx-xxx-xxxx

Cell Phone:

Format: xxx-xxx-xxxx

Street: *

City: *

State: *

Zip: *

Payment Method: *

Please bill my employer

Check (Please make checks payable to "SMSC")

Cash

Employer

Employer Name:

Employer Address:

Employer Phone:

Format: xxx-xxx-xxxx

Registration Form MUST be completed in its entirety and payment method selected.

*Payment is due no later than the first day of class.

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