Programmed for Pleasure enrolment form

Name

First Name

Last Name

Your pronouns

Email

Subject

Would you like to utilise a payment plan?

Pay in full

I would like to request a payment plan

If you would like to use a payment plan, please outline the exact dates and amounts you propose to make payment.

It is ideal the full program amount is paid prior to the program commencing (please speak to Jacqui directly if greater flexibility is needed). Jacqui makes every effort to extend as much flexibility as possible. She will confirm with you upon receipt of this request as to whether she can accomodate this request.

Programmed for Pleasure enrolment form

The Maple Inn