Fallon & Wilkinson, LLC

Class Registration Form

Class title


First and Last Name




[City, State & Zipcode]


Phone number



Email address




 I would like to receive updates in my email box periodically







Class experience

Other relevant experience/ interests





(may be required for some classes)

How did you

hear about us?



Cancellations are possible up to 5 days before the class with a full refund, save a $50 administrative fee.

Cancellations less than 5 days before the class cannot be accepted and will be charged in full


Please send this form with a check for the class registration fee in full to:


Fallon & Wilkinson, LLC

32 Bushnell Hollow Rd

Baltic, CT 06330

T/F: (860) 822 6790

info@fallonwilkinson.com  --  www.fallonwilkinson.com