CEAGB registration

Childbirth Education Association
of Greater Birmingham

COURSE REGISTRATION

Name: _______________________________________________________

Partner: ______________________________________________________

Address: _____________________________________________________

City/State/Zip: _________________________________________________

Phone Number: _________________ Attendant: ______________________

Baby's Due Date: ________________ Birth Place: _____________________

I am registering for the following class:

_____ Regular 6 week session - $75.00    Classes held at Sherwood Church of God, Roebuck/Huffman Area, on Thursday nights, Instructor: Valerie Moore, ICCE, CD(DONA)

_____ Weekend Get-A-Way - $75.00 +$65 for regular room + $65 for regular room or $85 for a suite. (AL area only).

_____ Refresher 4 week session - $50.00    Sherwood Church of God - Thursday nights -any 4 of the 6 classes.

_____ Refresher 4 week session - $40.00    Sherwood Church of God - Thursday nights

_____ Private In-home/In-Hospital Session - $40.00 per visit    A refresher private is typically 1-2 visits. A full private class is typically 2-3 classes.

_____ Study by Mail/Self Study - $50.00 includes a packet of information with instructions and one 2 hour visit with an instructor (Birmingham, AL area only).

If possible, I prefer to attend classes on the following nights - #1 being the first choice:
[Weekend] [Monday] [Tuesday] [Wednesday] [Thursday] [Friday]

Print, complete and return this form with your check for the appropriate amount to:

CEAGB
(205)856-0999

Please make your check payable to CEAGB.

CEAGB Homepage

Updated: April 17, 2000

_____ Regular 6 week session - $75.00 Classes held at Sherwood Church of God, Roebuck/Huffman Area, on Thursday nights, Instructor: Valerie Moore, ICCE, CD(DONA)	_____ Weekend Get-A-Way - $75.00 +$65 for regular room + $65 for regular room or $85 for a suite. (AL area only).
_____ Refresher 4 week session - $50.00 Sherwood Church of God - Thursday nights -any 4 of the 6 classes.	_____ Refresher 4 week session - $40.00 Sherwood Church of God - Thursday nights
_____ Private In-home/In-Hospital Session - $40.00 per visit A refresher private is typically 1-2 visits. A full private class is typically 2-3 classes.	_____ Study by Mail/Self Study - $50.00 includes a packet of information with instructions and one 2 hour visit with an instructor (Birmingham, AL area only).