REGISTRATION
FOR HCMI
If you are sending a check in the mail, please print
this form, fill it in and include your check. Please return the enrollment form
to:
PENZANCE EQUINE SOLUTIONS
200 South Street
Douglas, MA 01516
(508) 476-1317
NAME:_______________________________________________________________________
ADDRESS:____________________________________City:____________________________
STATE:______________________ZIP:______HOME PHONE(_____)_________ AGE:_______
WORK PHONE(_____)___________OCCUPATION__________BIRTHDATE_______________
____I am registering in PENZANCE HCMI as a new student (enroll fee $35)
____I am continuing my courses.
Please send me the following items:
Lesson, Course, Price
1.
_____________________________________________________________$_________
2.
_____________________________________________________________$_________
3.
_____________________________________________________________$_________
4.
_____________________________________________________________$_________
Subtotal $_________________
Shipping & Handling $_________________
Shipping & Handling cost: Add $2.50 to your order
Outside of U.S. & Canada add $10.00 to the above amounts $ ________________
New Student Enrollment fee (if applicable) $ ________________
TOTAL $_________________
*Foreign Orders: Due to the difference in currency exchange rates, only money orders
payments can be accepted. Please make sure money orders indicate U.S. Funds.
Signature of student______________________________________ Date_______________
NOTE: Please explain a little bit about your background with horses. Thank you.