Name:
_____________________________________
Address: ____________________________________
____________________________________
Telephone #: (day)
____________________________
(evening)____________________________
E-Mail: ______________________________________ (Class
confirmations will be emailed.)
Course(s):/Session
Date/Day Offered
Tuition & Registration Fee
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Total Due: (Tuition & $10.00 Registration
Fee) ________________
(Note: For registrations received after
February 3rd there will be a $15.00 fee.)