ENROLLMENT FORM FOR PROFESSIONALS' 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:
____ The Erotic Dominance Intensive for Women, Professional
Course (Total Cost $900)
(This is a three day course. Upon completion
of this course you will receive a Certificate of
Attendance.)
For Course Starting on: ________________________ Completed
on: __________________________
Send a $300 deposit with this application to reserve your
space. Balance due at start of course.
WORKSHOP FEES & CHARGES: The total cost is $900 which
includes a Registration Fee of $100 and Tuition Fee of
$800.
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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