Western Pennsylvania School for the Deaf

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RECEIPT

Choices for Children is proud to announce a new opportunity for families! Join us every other Wednesday evening for a sign language class from the comfort of your own home.

Our online classes are specifically tailored for families of infants & toddlers. Learn signs for everyday routines, master useful phrases, and practice signing with other families from across the state.

Classes will begin on Wednesday, September 18th and end December 18th, will occur every other Wednesday; and will be one hour in length from 8:00 p.m. to 9:00 p.m. Classes will use Google Meet for virtual instruction. There will be a registration fee of $20 per household. However, we ask that a family lists each member who will be attending the class.

Registration

Qty

Description

Amount

Total

Registration Fee

$20.00

per household

Total: $20.00

Attendee Information

Class Attending: *

Number of family members participating in the class: *

(please complete the information for each family member in the space below)

Attendee #1:

Full Name

Adult or Child:

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *