Registration form …

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For Office Use Only
Registration form …
Please print
Check box if you are a Tuality
Name _________________________________________________________________________________________
❏ Healthcare employee or volunteer.
Child’s name (if applicable) _____________________________________________________________________________ Child’s age ____________
Address ________________________________________________________________________________________________________________________
City
_______________________________________________________________________________
Phone (home) ___________________________ (cell) ______________________________ E-mail
State ______________ ZIP ___________________
___________________________________________
Classes I’d like to take …
Class name
Start date
Time
Fee
$
TOTAL
$
If you’re taking a class from the “Childbirth & Parenting” category,
please provide the following information (if applicable):
Your physician’s name __________________________________________________________________________________________________________
Expected birth date ____________________________________________________________________________________________________________
Your class partner’s name ______________________________________________________________________________________________________
Payment
If paying by mail, please allow at least a week for your payment to be received and processed.
❏ Check enclosed (payable to Tuality Healthcare)
Card number
Expires
Check No: __________
❏ American Express® ❏ Discover® ❏ MasterCard® ❏ VISA®
Name on Card
Verification Code
Signature
Frequently asked questions…
“How do I register for a class or classes?”
Phone: Call 503-681-1700.
Mail: Complete the accompanying form
and mail it, with your payment, to:
Tuality Health Education Center
334 SE 8th Ave., Hillsboro, OR 97123.
Fax: You may fax your registration with
credit-card payment to 503-681-1932.
Walk-in: Registrations are accepted with
payment at the Tuality Health Education Center.
“How do I know whether I’m registered for my class?”
With sufficient advanced registration notice,
we will send you a confirmation letter. Please
feel free to call 503-681-1700 at any time for
a verbal confirmation.
“What happens if the class is already full,
or if the class gets canceled?”
We will refund your payment.
“Why would a class get canceled?”
If there are not enough reservations to meet
our enrollment requirements, the class will be
canceled and you will be notified.
“Do you issue refunds?”
Yes, with the following requirements. You must
request a refund or transfer at least three weekdays
before the class begins. You may transfer to
another class only once. After you transfer to
another class, refunds are not available. For each
refund request, we will deduct a $15 processing
fee or the total class fee, whichever is less.
To register by phone call:
503-681-1700
Or mail registration and payment to:
Tuality Health Education Center
334 SE 8th Ave.
Hillsboro, Oregon 97123
Or fax registration and payment to:
503-681-1932
(Credit-card payment only.)
“What about inclement weather?”
If the Hillsboro School District closes due to bad
weather, we cancel Tuality’s daytime classes. If
Portland Community College cancels evening
classes, we cancel Tuality’s evening classes. Watch
local media reports for these local cancellations.
You may confirm Tuality’s weather-related class
cancellations by calling 503-681-1700, option 6.
Tuality Healthcare
Building a healthier community.
Community Education
For more information, call 503-681-1700. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Don’t forget signature for credit card.
09/08
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