1. Full Name:

2. E-Mail Address

3. Phone number:

4. What Clubhouse do you attend?

5. Tell us about your interest in food:

6. What are one or two professional goals you have for yourself?

7. What are three words that describe you?

8. Tell us about one of your favorite memories about food:

9. Can you commit to classes between 5pm and 7pm every Thursday?