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What's New with My Site?

PLEASE TAKE TIME TO FILL OUT EACH QUESTION AND MAKE SURE THE INFORMATION IS CORRECT AND SEND TO US. PRE REGISTERING HELPS US TO BE ABLE TO SAVE TIEM DURING THE SESSION.
Name:  
Email Address:
Phone Number can be reached at?
Local address ( in the states)
Is this your first time to the USA? YES
NO
What would be the Best way to contact you by: E-mail
Phone
Mail to local address
Please state best time to call you to set up the appointment if we call you?
If we set stuff up via e-mail will you be able to check your e-mail to make the appointment YES
NO
I know to call 518 636 1034 atleast 48 hours in advanced to confirm the appointment if it is set up on the web
Have you read the rules of our program and understand what our program is about? Yes
No
Unsure
I understand if I can't make an appointment I need to cancel with in 48 hours so we are aware you can't make it. Yes
No


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THANK YOU!

Completing this on line saves time during the session of having to fill this out since it is already done and we can print this out and have it when we meet.