Application for Enrollment

Please enter information in the form below to register to the 8-Week Horseshoeing class Aug-Oct .

First Name *

Last Name *

DOB (YYYY-MM-DD) *

Address *

City *

State *

Zip *

Phone *

Email *

Do you require on-campus housing?

Yes, I need a room on campus for the 8 weeks

No, I do not need a room on campus for the 8 weeks

Are you left-handed or right-handed?

I am left-handed

I am right-handed

Will you be funding your tuition with the G.I. Bill?

Yes

Amount

Payment processing fee

Gross amount

Payment method

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*