Shirley Vickers Academy
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Fax & Mail Reservation Form

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btn_lg.png (164 bytes) Name ______________________________________________________

btn_lg.png (164 bytes) Street Address __________________________________

btn_lg.png (164 bytes) City _________________ State ___ Zipcode __________

btn_lg.png (164 bytes) Phone _______________ FAX ______________________

btn_lg.png (164 bytes) Profession ____________ Left or right Handed _______

btn_lg.png (164 bytes) Class Dates and Place Requested ___________________

btn_lg.png (164 bytes) How did You Hear About the Class? _______________

btn_lg.png (164 bytes) Would You Like to be on Our Mailing List?  YES  NO

Please note:  Regarding the classes in Pine, Arizona, we do not provide transportation to and from class.  Rental cars are available at the airport in Phoenix or in Payson.  Accommodations in Pine in winter are inexpensive and available.  Summer rates go up and pre-book is advised.   This area is a cool summer resort high in the pines and mountains of northern Arizona, 72 miles south of Flagstaff and 2 hours north of Phoenix on Highway 87.

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Copyright 1997-2010 Shirley Vickers. All Rights Reserved
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For any other inquiries, please call (928) 476-3703
This page was last updated: 04-06-2010