The Tech Club

What Does it Offer
Register

How to Register

Please complete an on-line intake form.
The facilitator will connect with you.
You will receive an email confirmation and a request for payment before the first day of the month.
Please pay on the website under Pay On-line or Payment Information. Receipts will be issued automatically.
Payment is due, for returning participants, on or before the first day of each month.

Please fill out this form to Register for Tech Club

Date of Birth*
MM slash DD slash YYYY
Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email*
Emergency Contact*
Please provide any additional information that we should know about you.
Would you like to receive our newsletter by email?*
- Yes
- No

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