The Arc Wisconsin Academy: Group Registration

Thank you for your interest in registering a group for The Arc Wisconsin Academy. Please complete this form to begin the registration process and reserve your seats in the class. This registration will not be complete until The Arc Wisconsin has received your payment.

What is the name of the organization registering a group of students?*
Who is the person registering this group of students?*
First Last
How many students are you registering as a group?*
Which courses will this group of students be taking?
- The Arc Wisconsin Academy both courses (12 classes + bonus class)
- HealthMatters™ Course starting April 12, 2021 (six classes, each class offered 2x/month)
- Self-Advocacy Leadership in Action Course starting October 2021 (six classes, each class offered 2x/month)

What are the names of the students you are registering for? Please type or paste in all student first and last names
Name
First Last
Name
First Last
Name
First Last
Name
First Last
Name
First Last

What is the email address where class materials for this group of students should be sent each month? (you may provide more than one email if students will receive their own materials)
Email Address 1*
Email Address 2
Email Address 3
Email Address 4

You will be sent an invoice for this group of students based upon your group rate.
Organization Name*
Contact Email
Street Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What are the names of the students you are registering for? Please type or paste in all student first and last names

What is the email address where class materials for this group of students should be sent each month? (you may provide more than one email if students will receive their own materials)

You will be sent an invoice for this group of students based upon your group rate.