FourWinds Academy Class/Course Registration Form

It's easy to register! Please write very very clearly

Just print out this page or the PDF file, fill in and mail it

Name: __________________________________________________________

Address: ________________________________________________________

City_________________________ State: _______________ Zip:___________

Phone Numbers: ____________________ Mobile: _________________________

Email: __________________________________________________________ 

Course or Class Name: _____________________________________________ 

Date of Course/Class: _____________ Tuition: $________ Material Fee: $_________

Optional Donation: $_______ *Payment Plan: Yes No

Total: $_________

If paying by credit card (do not send via email): Circle card used: MasterCard Visa American Express Discover

Name on Credit Card: _____________________________________________

Billing Address of Card: ____________________________________________

(If different from home address) ________________________________________________________________

Card Number: _____________/___________/_____________/_____________

Security Code (on back):_____________ Expiration: ______/_______/_______

Make checks payable to FourWinds Academy. Mail to FourWinds Academy, 7445 FourWinds Drive, Cincinnati OH 45242
Federal law requires us to request ethnicity/race: please circle appropriate category/s: American Indian or Alaska Native / Asian / Black or African American / Native Hawaiian or Other Pacific Islander / White

FourWinds Academy reserves the right to cancel or reschedule courses and classes. Cancellation Policy: Written cancellations (email) accepted up to 14 days prior to course or class commencement and incur charges of 10% of the tuition, balance to be credited. Credit expires after 360 days and can only be transferred once. Communication is done via email and students are responsible for ensuring that they know the date, time and location of the course/class 7 days before.

Questions: Call (513) 891-8062

*Payment Plan Explained: For courses in which tuition exceeds $150, you can pay in 3 installments, with the final installment in the same month as the course. Must provide either valid credit card details or post-dated checks.

Four Winds Academy is a 501(c) 3 nonprofit organization and admits students of any race, color and national or ethnic origin. Fundraising ID #31296