Program Class Update Form

Please complete this form for each of your Arthritis Foundation Programs for Better Living classes that you lead.
* required information
Contact 
Contact Information
First Name:*
Last Name:*
Company Name:*
Email:*
Address Line 1:*
Address Line 2:
City:*
State:*
ZIP/Postal Code:*
County:*
Phone:*
Cell Phone:
Fax:
Additional Information
What type of Life Improvement Series Class are you teaching?:*
Where does your class meet (include full address with zip code please):*
What day or days of the week do you meet?:* Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
What time does class begin and end? Example: 10:30am - 11:30am:*
Beginning date of class:*(mm/dd/yyyy)
Ongoing?:* Yes
No
If no, please enter the end date:(mm/dd/yyyy)
Additional information that needs to be included on the Program List:
Phone number to contact for more information about the class:*
        

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