15329 Bonanza Rd.
Victorville, Ca 92392
Choir Class
Fill out the form carefully and sign up of each participant.
Class Date
August 11th - Tuesday 5-630pm
Class Date
August 25th - Tuesday 5-630pm
Class Participant Name
*
First Name
Last Name
Family/Parent/Guardian Name
*
First Name
Last Name
City where you live
*
Age
*
Gender
*
Male
Female
N/A
Number in Household
*
Number over age 62
*
Mobile Number
*
-
Area Code
Phone Number
Ethnicity
*
Hispanic/Latino
African American
Asian
White Caucasian
Other
E-mail
*
My Products
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August Monthly Family Donation
$100.00
$
100.00
November Monthly Family Donation
August IRC Reimbursement
$100.00
$
100.00
IRC Reimbursement Payment for Recreational Services, Basketball, Dance, Karate, Soaring Eagles
Already donated this month / Self Determination
Free
$
Free
Please hit PayPal to check out. (Zelle - rocknourdisbilities@gmail.com)
Total
$0.00
$
0.00
Payment Methods
Debit or Credit Card
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make your payment.
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