Class Inquiry Form

Use this form to inquire about information on a class or to request registration in the class.

Name

This field is for validation purposes and should be left unchanged.

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Hidden Administrative Fields

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Email – Leads

educarer@rie.org educarer@rie.org

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RIECENTER

YES

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Instructor Website URL

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Email – Class Contact

Course/Class

Thank you for inquiring about the following course/class. Once you submit your form, the coordinator for that class will receive your form right away. Please allow a business day for a reply, especially when distant time zones are involved.

Course Name

Instructor

Course Date

Course Location

Days, Times & Time Zone

About You

Please tell us a little bit about yourself and how best we can contact you to follow up?

Name(Required)

First Last

Pronouns

Child's Name(Required)

First Last

Pronouns

Child's Birth Date (or Approx Expected Date)(Required)

Approx Expected Date(Required)

Your Location(Required)

City State / Province / Region ZIP / Postal Code Country

How Can We Reach You?

How can we best reach you to discuss the course and your interest in registration?

Preferred Method of Contact(Required)

Your Email Address(Required)

Email Address Confirm Email Address

Your Phone

Best Time to Call You

I'd like to keep up to date:(Required)

What do we need to know?

Please let us know what’s on your mind and any questions you have so we can be best prepared when we contact you? Ask away.

Your Comments/Questions(Required)

Class Inquiry Form