classregistrationandpayment

Name
Address
City	Email:
State, Zip	Phone:
Class:
Locatoin:
Date:
Cost:

Class Registration and Payment
Please print this form and send with your payment to:
Deborah V. Smith
1070 Township Line Road
Phoenixville, PA
19460
Questions: 610.917.8265
jsdeast@verizon.net