Interest Form

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Complete this simple form to let us know if you're interested in EITHER attending a two-day training OR a one-day refresher course AND what day(s) you're available

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*Name: *

Street Address

*City, State, Zip Code *

E-mail address: *

*Confirm E-mail address *

*Cell Phone # *

Other Phone #

What dates are you available to attend a 2-day training or a 1-day Leader Refresher Course? *

*How many laughter classes have you been to and where/when? *

*Why do you want to take the certified training or refresher course? *

*What do you plan to do as a certified leader, if anything? *

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CLICK ON THE "Send Form" BUTTON BELOW. THEN, SCROLL UP FOR CONFIRMATION THAT YOUR FORM WAS SENT OR TO SEE IF THERE ARE ANY ERRORS

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