JLI Registration Form

 

Please fill in the form below to register for the 2015 adult education series "Art of Parenting" in Golders Green.
 

* Denotes required field:

 Name * 
 Address Line 1 *
 Address Line 2
 City *
 County *
 Postcode *
 Country *
 Email address *
 Phone *
This is my home  business address

Payment:

 Visa   Mastercard
 £50 per person for 6 classes plus £10 for workbook*
 Card Number *
     Expiration Date *

Note:

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