Rosh Chodesh Society Registration 5783

Your Registration Info

First Name *

Last Name *

Email Address *

Phone

Registration Fee

Full Course - $ 100.00

Please select which classes you would like to attend

Lesson 1 - $ 18.00

Lesson 2 - $ 18.00

Lesson 3 - $ 18.00

Lesson 4 - $ 18.00

Lesson 5 - $ 18.00

Lesson 6 - $ 18.00

Lesson 7 - $ 18.00

RCS Book Fee

Purchase Book - $ 25.00

Total

Authorize.net (Credit Card)

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *