Institute of Urban Homesteading: Class Registration Form

The Institute of Urban Homesteading
Online Registration Form

Today’s Date
Name
Address
City	State	Zip
Best Phone
Alternate Phone
Email

Enter the name and date of each class you are registering for and the amount you will pay for each class.
Please refer to the information on our sliding scale policy to determine what to pay.
Submit an additional registration form if you are registering for more than three classes at one time.

You may register two people for the same class on one form. Simply enter the class and payment amount twice and include the name of the second person in the comment box below.

Name of Class	Date	Amount
1.		$
2.		$
3.		$
	subtotal	$
	handling fee (PayPal or credit card orders only)	$
	total	$

How will you be paying?
Online Payment	PayPal or Credit Card. When you click “Register” you will be redirected to a page where you may either login and pay with PayPal or use a credit/debit card to make a a one-time payment (click on “Don’t have a PayPal account?”)
Personal Check	If you check this option please make out your check to IUH and send it to 842 Ferry Road, Grants Pass OR 97526
Credit Card	Credit/Debit Card Direct You may fill in your credit card information in the comment section below (# , expiration & 3 digit code) OR Call (510) 927-3252 and leave it on our voicemail (write our # down before hitting submit!). We will delete all record of your card information once we have processed the card.
Gift Certificate	Please enter the number of the certificate here:

	Comments:

I am a robot that is maliciously trying to figure out how to use this form to send spam. (wrong answer) I am a human and I have read and assent to the IUH Cancellation Policy and Registration Policies. (right answer)