JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
CARE 3 Day Intensive - Dalton, PA
June 28-30, 2024
Please fill out this brief form. A receipt and details will be emailed to you once payment is received. Please note: communication is best made with Terra McAulliffe via terra.em11@tutanota.com for any questions or concerns.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name
*
Your answer
Email
*
Your answer
Phone number
Your answer
Address
Your answer
How did you hear about this training?
Your answer
What interests you most about this training?
Your answer
Choose how you would like to pay?
*
Pay in full: $800
Pay half deposit now ($400) and remaining amount ($400) by June 14, 2024
Please select method of payment and follow instructions below. Include the date of training in notes/memo and please use friends & family to avoid additional fees.
*
Paypal: Use this link:
paypal.me/TerraM81
Venmo: Use this handle: @Terra-McAulliffe with last four 2635
Mail a check to Terra McAulliffe, 1118 SR 92 N, Tunkhannock, PA 18657
Thank you!
Look for an email response with further details within 48hours of payment received. Please remember it is a human on the other side of this, and I will be working to respond to you as soon as possible.
-Terra McAulliffe
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
