Spanish Plus: Specializing in Health Care Spanish since 2001

Spanish Plus

Class Registration

Registration Information
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
State:
Contact Information
Daytime Phone:
Evening Phone:
Email:
Class Information
Class Date & Location:
Amount Enclosed:	(USD)
License #:
Other Information
Comments (add multiple attendee names):	Enter comments here!

If you are registering more than one person please give the names of each additional person in the comments box. Include the license number for those needing continuing education credit. To pay for the class online with a credit card push the submit button and follow the prompts. If you prefer to send a check print this page and include a check made out to Spanish Plus and send to - Spanish Plus, 7552 Richland Ave. Kansas City, KS 66111

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