Private Lessons or Fargo Assessment Registration Form Pool Lessons – Mike Stratton First Name * Last Name * Occupation Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Phone * Email * Birthdate * How Did You Hear About The Club? FacebookClub MemberWebsiteAnother ClubFriendOther How Did You Hear About The Club? Areas of Interest (Pool or Snooker – Check All That Apply) * Practice Lessons Club Matches & Pick-Up Games League Play 1 Pocket Pool 8 Ball Pool 9 Ball Pool 10 Ball Pool Straight Pool Banks Pool Challenge Ladder Tournaments High Break Board (Snooker Only) OtherOther How would you rate your pool or snooker experience? Beginner: Little to basic understanding of the game and no (or little) experience playing on a pool or snooker table. Novice: Basic to mid-level understanding of the game, strategy and experience playing club level matches. No (or little) experience playing in leagues or tournaments. Amateur: Full understanding of the game, rules, strategy and several years’ experience playing club level matches and some experience playing in leagues and tournaments and possibly winning prize money. Professional: Full understanding of the game, rules, strategy and several years’ experience playing professional level leagues and tournaments and winning prize money etc. Type(s) of Instruction You Are Interested In: * Beginner/Intermediate Orientation Classes Training on the Illuminating Cueing Arts Projection System Video Analysis Group Lessons Private Lessons Youth Lessons Snooker Lessons OtherOther Please describe specific instruction goals you would like to achieve: Do you have a current Fargo rating? Yes No Fargo Rate Assessment: Would you like to schedule an assessment to establish a starting Fargo Rate? Yes No Fargo Rate: (Please enter current Fargo Rate): We will contact you soon to schedule a day and time to schedule your first orientation or lesson. * I accept the terms and conditions Submit If you are human, leave this field blank. Δ
