Southern Etiquette Consultants Registration Form

Southern Etiquette Consultants Registration Form

Class Registration for Boys and Girls, Kindergarten - 12th Grade
Please fill out this form to register for our etiquette classes.

Sections with a red asterisk* are required.
Student Name *

First Name Last Name
Age *
Grade *
Please list any food allergies or none: *
Name of Parent *
Phone Number *
E-mail *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Please Select Session, Day and Time *
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Winter 2022 K-6th Grade Classes $ 300.00
6 - 1 hour etiquette lessons

Must Select Class Session

Winter 2022: 7th-12th Grade Class $ 300.00
2 - 2 hour etiquette lessons

Must Select Class Session
I give permission for Southern Etiquette Consultants to use pictures of my child for promotional purposes.
YES or NO: *
How Did You Hear About Us? *

Conversation with owner Email announcement Online search Print advertisement School flyer Referred by friend
Friend who referred you:
Full Name
Get Class Updates and FREE Etiquette Tips!

Yes, I would like to receive Updates & Tips from Southern Etiquette Consultants via Email
Additional Comments:
We process credit card transactions through PayPal. Upon clicking the submit button, you will be automatically transferred to the PayPal website for secure checkout. You do not need a PayPal account to use this online registration form. Thank You for registering!

Please email us at rebecca@secprotocol.com if you have problems registering.
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