First name and Middle Initial *

Last name *

Email *

Phone Number *

Plan to Attend: Next available session (please notify me of dates)

1st time slot 8:30am

Is this your First, Second, or Third Choice?(type N/A if you didn't pick this time slot) *

2nd time slot 10am

Is this your First, Second, or Third Choice? (type N/A if you didn't pick this time slot) *

3rd time slot 11:30am

Is this your First, Second, or Third Choice? (type N/A if you didn't pick this time slot) *

4th time slot 1pm

Is this your First, Second, or Third Choice? (type N/A if you didn't pick this time slot) *