Class Registration Form

2011Spring Classes
April 11, 2011 - June 18, 2011

2040 N Dixie Hwy - Wilton Manors, FL 33305 - (954) 463-9005 - FAX (954) 764-6522 - info.prideuniversity@pridecenterflorida.org -
www.pridecenterflorida.org

Pride Center Members Save 25% Off Tuition Fees

Pride University is highly respected and valued as a leader and trend setter for growth and life-long learning
opportunities for the LGBT community while enhancing the life of each participant.

First Name: Last Name:

Address:

City: State: Zipcode:

Home: Cell: eMail:

Please indicate the course(es) you wish to attend. The Fall Quarter is 10 weeks in length. The tuition for each class may vary. Non-Members
pay $30 more than for Members. Become a Member and SAVE! An additional materials fee is indicated as [$$] PAYABLE DURING THE
FIRST CLASS.

Are YOU Pride Center Member? Please place "X"s in selecting the course(s) you wish to take.

yes no
Ballroom & Latin Dance: Daryl Philibert
Friday, 7:00pm to 8:00 pm - $95/ $125
Salsa: Daryl Philibert
Friday, 8:00pm to 9:00 pm - $95/ $125
Creative Watercolor: Joyce Gilbert -- [+ Approx. $100 Materials Cost]
Saturday, 11:00am to 1:00pm - $95 / $125
GetFirm Boot Camp: Allison Parnell (8-week course) This class is off campus at a local gym
Weekdays, 6:30pm - 7:30pm - $95 / $125
Keys to Becoming a Successful Business Owner/Manager
Saturday, 1:00 pm to 3:00pm - $95 / $125
The Practice of Yoga: Glenn Lawson
Wednesday, 7:00pm to 8:00pm - $95 / $125

Number of courses ______ X NON-Member fee $125 = $ _______________ Become a member and SAVE!

Number of courses ______ X Member fee $95 = $ _______________ Pride Center Member # __________

Signature: Date:

Total number of registered courses: TOTAL cost for Classes: $ due.

Pay using PayPal Please provide Member # ___________________

My check is payable toPride Center is enclosed (class registration isnot complete until check clears)
Please charge my Credit Card American Express MasterCard Visa

Credit Card Number ExDate

Mail this application to:G

Pride Center, 2040 N. Dixie Hwy, Wilton Manors, FL 33305 or Fax to: 954-764-6522