Foothills Spring 2019 Catalog

Foothills Adult & Continuing Education 1.800.300.4781 • 54 REGISTRATION FORM ENRICHMENT CLASS REGISTRATION FORM - SPRING 2019 Eligibility: NO participants under 18 years of age. First Name ________________________________ Last Name ________________________________ Street ____________________________________________________________________________________ Town _____________________________________________ State _______ Zip Code ________________ Home Phone _______________________________ Work Phone ________________________________ Cell Phone __________________________ E-Mail (required*) ___________________________________ Please check if you have a disability. Call for special accommodation needs. *Necessary for communications regarding class updates ONLY AMOUNT LOCATION COURSE TITLE START DATE TIME **To help avoid cancellations PLEASE register in advance at least 2 weeks before class start date ** Thank you for signing up for a Foothills Adult & Continuing Education class! Please let us know how you received this brochure: mail friend business vehicle/van sign We do not confirm registrations. Please mark your calendars. PAYMENT ENCLOSED : ( NO REFUNDS UNLESS A CLASS IS CANCELLED) Check # ____________________ Make check payable to: EdAdvance Credit Card Payment Card# ____________________________________________________ Exp.Date ____________ CVV# _ _________ NameofCardholder ______________________________Signature______________________________________ Senior Citizen Y N Senior Citizens (62+ years) may take a 10% discount* *SORRY, SENIOR CITIZEN DISCOUNTS DO NOT APPLY TO CLASSES PRICED at $20 or less, COMPUTER CLASSES, FOOD HANDLER, CERTIFIED NURSE AIDE (CNA), BOATING, FENCING, TENNIS, GOLF AND TRIPS *FOUR EASY WAYS TO REGISTER * FAX 860.567.3381 PHONE 1.800.300.4781 or 860.567.0863 MAIL/IN PERSON EdAdvance Attn: Foothills Adult Education 355 Goshen Road, P.O. Box 909 Litchfield, CT 06759-0909 ONLINE **Always bring a flashdrive to computer classes**