| Application
________________________________________________________
NAME
________________________________________________________
ADDRESS
________________________________________________________
CITY, STATE ZIP
________________________________________________________
HOME PHONE WORK PHONE
________________________________________________________
FAX E -M A I L
Send this form, with a non-refundable $25 application fee,
payable to The Pfeiffer Center, to
THE PFEIFFER CENTER
260 HUNGRY HOLLOW ROAD
CHESTNUT RIDGE, NEW YORK 10977
Upon acceptance, you
will be sent a tuition agreement.
You will be sent a confirmation notice along with a
registration packet that you should bring with you
to the first session.
|