Educated Arrivals

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Educated Arrivals Registration Form

Please Fill out the form Below. You can either email it directly or print it out and mail it with deposit to Educated Arrivals 303 17th Ave. S. Brookings, SD 57006.
After you click send your information will be emailed to us. You will then be returned to this blank registration page.
If you wish to use Paypal to pay for the class you can do so at the bottom of the page. Please note that two additional dollars will be added to the cost to cover Paypal fees when you choose to pay online.


Name
Support Persons Name
Session Registering For
Due Date
Moms Occupation
Support Person's Occupation
Address Line 1
Address Line 2
City
State
Zip Code
Home Phone() -
Cell/Work Phone() -
E-mail Address
Planning to Attend Newborn Preparation Class Y/N
Questions/Requests/Concerns
Payment Type (Paypal or Check by mail)
Payment Choice

 

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