Class Registration Form to Print

Name:

Billing Address (for credit cards if different than mailing address):
City State Zip Code

Phone: Email:

Pay by Check or Credit Card

Credit Card Type Visa Master Card Discover American Express Credit Card Number Exp. Date
Security Code: 3 digits on back of card or 4 digits on front of American Express.

Pay Deposit(s) or Pay the Full Amount(s)

Cancellation Policy

I hope that the following cancellation policy is workable. This policy is needed to keep class sizes small, but also keep the enrollment at the expected number of students. At times circumstances arise beyond your control—our aim is to balance your needs with the class size requirements. Please feel free to call if you have questions.

Cancellation . . .

• within one week (of your registration) = a Full Refund.

• up to 60 calendar days before the first day of class   = Refund - $100 registration fee.

• < 60 days before the first day of class = No Refund. Full tuition must be paid.

All cancellations must be in writing by emailing to kelly@kellymehler.com or posted mail so that we both have a written record.

To register for weeklong classes a deposit of $300 is required. The full amount must be paid 60 days before the class date. Weekend classes must be paid in full. Make checks payable to Kelly Mehler, LLC. print and either fax or mail this form after filling out. Feel free to call (859)986-5540 or email kelly@kellymehler.com with questions. Fax: (859) 986-1233 Mailing Address: Kelly Mehler P.O. Box 786, Berea, KY 40403.