ATM Fax & Mail Registration Form Print and/or save and print this form and then fill out and fax or send to: All That Matters 315 Main St, Wakefield, RI 02879 Fax (401) 788-3648 Phone: (401) 782-2126   Name: ________________________________________________________ Address: ______________________________________________________   Phone: (day) ______________________ (nights) ______________________   Course Title(s) Including Date(s): ______________________________________________________________ $_________ ______________________________________________________________ $_________ ______________________________________________________________ $_________ ______________________________________________________________ $_________ ______________________________________________________________ $_________   Non-Refundable Registration Fee (required):___________________________ $ 5.00 Donation To ATM Scholarship Fund (optional): ________________________$_________ _________________________________________________________ Total: $_________ Payment Method (check one): Visa ___ MC ___ Check ___ Money Order ___ Gift Card ___ Total $________ Credit Card #: ___________________________________________ Exp. Date _________ Gift Card #: ___________________________________________ Signature (credit card only): __________________________________________________ Are You On Our Mailing List? (check one): Yes ___ No ___ For online updates of events - list your email address _______________________________

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