ENROLLMENT FORM FOR PLAYERS' EROTIC DOMINANCE INTENSIVES
Please
do NOT send this enrollment form and registration fee unless
you have
already
returned
the
Application
Questionnaire
and have
had a phone conversation with Cléo Dubois during which
we have both decided that the course is right for you.
Cléo Dubois Academy
Post Office Box 2345, Menlo Park, California 94026-2345
ENROLLMENT
AGREEMENT
For Applicant Below
Student Name ________________________________________________________________________
Postal Address ________________________________________________________________________
City _________________________________ State_________ Zip__________
Country______________
Home Phone _____________________________ Cell Phone ___________________________________
Best Time to Call ______________________________________________________________________
Email Address ___________________________________________
This agreement is a legally binding instrument when signed by
the student and accepted by the Academy of SM Arts. Your signature
on
this agreement acknowledges that you have been given reasonable
time to read and understand it and that you have been given a
description
of the course of instruction and materials provided, and have
read and are aware of the refund policies stated below.
This Agreement is for the following course: This Agreement is for the following course (check and complete
one below):
____ The Men's Intensive Weekend (Total Cost $700)
____ The Women's Intensive Weekend (Total Cost $700)
For Course Starting on: ________________________ Completed
on: __________________________
Send a $200 deposit with this application
to reserve your space. Balance due at start of course.
WORKSHOP FEES & CHARGES: The total cost is $700 which includes
a Registration Fee of $100 and Tuition Fee of $600.
REFUND
POLICY: The Student has a right to cancel this Enrollment Agreement
and obtain a refund by providing
written notice
to the Academy of SM Arts. A deposit refund, less the
$100 non-refundable
Registration Fee, will be granted if a cancellation notice
is given
at least 14 days prior to the course start date.
STUDENT SIGNATURE:____________________________________________
DATE:_________________
ACCEPTED BY THE ACADEMY: _____________________________________
DATE:_________________
DEPOSIT ENCLOSED: $ ___________ Check _____
Money Order _____ Paid by Credit
Card _____
Please copy and paste this into a word processing program (or
click here to download an MS Word document). THEN COMPLETE, SIGN & RETURN
THIS AGREEMENT WITH YOUR DEPOSIT TO:
Cléo Dubois Academy, P.O. Box 2345, Menlo Park, CA 94026-2345
PAY
ONLINE:
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