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Want to request a class with us?

Welcome! To request a class reservation, choose:
  • Class Title
  • Day
  • Month
  • Date

Upon receipt of your e-mail, one of our staff will confirm your reservation by phone and make payment arrangements with you.

Note: If you are sure of which classes that you wish to enroll, fill out this form and print it. Then, send the form and your payment to the address listed at the bottom of the page.


Class 1
Class Title

Day

Day

Day


Class 2
Class Title

Day

Month

Date


Class 3
Class Title

Day

Month

Date


First and Last Name :

Street Address and Apartment/Suite # (if applicable):

City
State
  Zip Code
Home Phone
Work Phone
Fax
E-mail

Send Checks to:
Internet Universtiy of America, Inc., (925) 933-0500
1381 Locust St., Walnut Creek, CA 94596


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