All fields in bold are required

Name:   Address:  
City:   State:   ZIP: Telephone (daytime): 
Cell-phone: Fax:
Email:
Name of proposed class or workshop:
Book(s) or other resources to be used (books will be provided through Simply Divine Books & Things)
(For all Light Universityclasses at least one book is required.)
Preferred day:
Second choice day:
Preferred time:
Semester is 6 weeks.
How many sessions do you need? 		Class registration fee is $111.00 plus any additional fees for course materials.
Please give us a suggested write-up for the catalog and other promotional materials (you may email an attachment to info@lightu.org)
Planned method of facilitation (i.e., didactic, experiential, etc.)

Student preparation for the class or workshop
Advanced reading required
Biographical Information (degrees, training, etc.)
Please enter below any additional comments: