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Registration Form

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Please provide us with the following information about you:


Please select your choice for enrollment:

Private Room    Double Room    Day Student 
Roommate Requested  
( For double room only, if roommate is not requested, one will be assigned ) 
Smoker/Non Smoker  
Name of  Guest           

Please provide us with your Teacher choices:
1st Teacher        
2nd Teacher       

Please provide the following information for the deposit:
(We accept VISA, MASTERCARD, DISCOVER, AMERICAN EXPRESS, and PAYPAL)
Type of Card:    
Card Number:   
Expiration:         
Security Code: