Please the application, then mail to:††††††††††††††††††††††††††††††† †††††††††††††††
PO Box 134
New Madrid MO 63869
Print your name, as it appears on your driver's license.
Name Date of Birth
City, State & Zip
Home Phone Cell Phone
Best time to reach you by phone
Students are scheduled on a first come/first serve - prepaid basis. Early registration is suggested.
There are 2 classes per month and each class is 2 days in length.
July 19/20 August 16/17 September 20/21 October 4/5
Preferred dates: 1st choice: 2nd choice: 3rd choice:
Course fee is $200.00 per person Make checks payable to: BMT
Registrations within 7 days of class date require cashierís check, money order, credit card or cash. †††††† †††††††††††††††
A refund, less a $10.00 processing fee, will only be issued for cancellations made MORE than 7days in
advance or in the event of an emergency. In the event of an unsuccessful completion, no refund will
By signing below, I signify that I have read and understand the refund policy.
Applicantís Signature: †††††††††††††††††††††† ††††††††††††††††††††††††††††††† ††††††††††††††† † Date: † ††††††††††††††††††††††††††††††† ††††††††††††††† †
**If under the age of 18: Parentís Signature ††††††††††††††††††††††