EquiClick101 Registration Form:
                                 from PENZANCE EQUINE SOLUTIONS

Please print out this form, complete it and mail it with your check or money order to:

PENZANCE EQUINE SOLUTIONS
200 South Street
Douglas, MA 01516

NAME:______________________________________________________________DATE:______________________

ADDRESS: _____________________________________________________________________________________

CITY:____________________________________________STATE:____________ZIP:_________________________

TELEPHONE:_____________________________________E-MAIL:_________________________________

I am enclosing $_______________________    check/money order for registration in Equiclick101 with PENZANCE.

Please forward the URL to the course to me by email as soon as my check clears.                      Thank you.

__________________________________________________________   __________________________
Signature                                                                                                         Date