2. Alcohol Awareness -IN PERSON CLASSES ONLY Class Sign-up. WE NO LONGER OFFER VIRTUAL CLASSES!
4. First Name*
5. Middle Initial*
6. Last Name*
8. Street Address*
9. City*
11. State*
12. Zip Code*
13. Phone Number*
    xxx-xxx-xxxx
14. E-Mail Address*
16. Name of Establishment/Organization
17. Special Note:

    A government issued ID is required to attend the class. Please bring your drivers license,  identification card, military ID or US Passport.

18. Class Date*
    -- Select One --IN PERSON- Thursday May 11,2023 at 9amIN PERSON-Tuesday June 6, 2023, at 5:30pmIN PERSON-Tuesday June 27, 2023, at 5:30pmIN PERSON- Tuesday July 11, 2023 at 5:30pmIN PERSON Thursday July 20, 2023 at 5:30pmIN PERSON Tuesday August 8, 2023 at 5:30pmIN PERSON Thursday August 24, 2023 at 5:30pm

    You will receive an email confirming your IN PERSON CLASS registration one week prior to the class date and time you have chose. **SCROLL TO THE BOTTOM OF THE PAGE TO HIT SUBMIT FOR THE REGISTRATION TO COMPLETE** PAYMENT LINK IS SEPARATE

    **WE NO LONGER OFFER VIRTUAL CLASSES**

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20. 1. Receive an email copy of this form.
21. Email address

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22. Submit

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