Please print this application and return it
with your deposit.
Application for Certification Course
Name:____________________________________________________________________________________
Address:__________________________________________________________________________________
Phone:___________________________________________________________________________________
Email Address: ____________________________________________________________________________
Emergency Contact:_________________________________________________________________________
A deposit of $500 is due with this application. Balance is due one week before class. You will receive a
"Certificate of Completion" on successful completion of the course.
PAYMENT PLANS ARE AVAILABLE.
Please make checks payable to:
ReDazzle Design Call 230-4586 with questions.
2306 W. North Five Mile Road
Spokane, WA 99208
Official Use Only
Date Received _______ Date Deposit Received_________Second Payment_________Final Payment_________
