Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Please indicate your class selection. (*You may change this later)

1 teacher - 1 class per week - over 7 consecutive weeks - $50

2 teachers - 2 classes per week - over 7 consecutive weeks - $100

3 teachers - 3 classes per week - over 7 consecutive weeks - $150

Unlimited teachers - Unlimited classes per week - over 7 consecutive weeks - $200

What days/times do you plan on attending?

Tuesdays - 9:30 AM

Tuesdays - 11:05 AM

Wednesdays - 9:30 AM (Zoom Only)

Thursdays - 9:30 AM

Thursdays - 11:05 AM

When do you plan to start taking classes?

MM

DD

YYYY

Are you here in Rhode Island mainly due to your spouse/partner?

Yes

No

If you answered "Yes" to the question above what best describes your spouse/partner? My spouse/partner is a...

Masters Student

PhD Student

Post-Doc Student

Visiting Professor

Other

Local Permanent Resident

International Employee (For example: H1B worker)