Makings of a Gentleman Form

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The Making of a Gentleman Registration Form

* Indicates required field

Title Preference *

Please choose your title preference so we know how to formally address you.

Participant's Name *

First

Last

Age *

Email *

I am registering for *

Phone Number *

Full Name of Chaperone *

If the person registering is younger than 21yo please enter the full name of the chaperone. Chaperone needs to register as a student for the same class.

Allergies / Dietary Needs *

Light refreshments are offered during some classes. Please let us know if you have any food allergies.

Profession *

Alumnus/Alumna *

Let us know if you have attended any of our courses in the past.

We photograph and/or videotape some classes *

I allow my picture to be used in promotional material Please do not post any pictures of me

I am interested in the following topics: *

Modern concept of masculinity Chivalry & honor in everyday life Posture and class Fashion guidance Fine-tuning communication with family, partner, colleagues Making and maintaining meaningful friendships Rules of Netiquette: email, phone, cell phone, and social media Fine dining skills & wine pairing Networking and expanding professional connections Entertaining at home and work Choosing the right present for the occasion Dating etiquette Creating & keeping professional boundaries Dancing and socializing The Art of Small Talk Traveling etiquette *Other {please share your goals on the right}

How did you hear about The Etiquette Academy? *

Goals I would like to accomplish: *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Would you like to receive our monthly newsletter? *

Yes, please. I love etiquette tips and learning about new programs. No, thank you. I receive too many emails already.

What would you like to receive more information about? *

Etiquette tips for kids Programs for kids Etiquette tips for professionals Professional programs for adults Social etiquette tips for adults Social etiquette programs for adults

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