WSET Student Enrollment Form 2018-2019

WSET Enrollment Form 2018-2019
Last Name*
First Name*
Mailing Street*
Mailing City*
Mailing State
Mailing Zip*
Email*
Secondary Email*
Phone
Date of Birth*
Title*
Employer*
Twitter*
Facebook/Instragram*

Payment is accepted by cash, check, major credit card (in person only via Square) and PayPal submitted to:

Deborah Parker Wong                                                                                                    559 Ortega Street                                                                                                              San Francisco, CA 94122                                                                                                PayPal: dpwsf@pacbell.net

The information supplied on this form will be shared with WSET Awards but is otherwise confidential.