ADULT EDUCATION Fall 2008
REGISTRATION FORM
(Separate payment for each course, program, or trip)

This registration form must accompany your check, cash, or money order.

NAME : e-mail address:

ADDRESS:

TELEPHONE:

(Home) (Business)

Today's Date:

Please enroll me in the following course:

TOTAL ENCLOSED $

Senior Citizen: (Age 65 or over. Check here if applicable.)

Town Employee: (Check here if applicable.)

IF PAYING BY CHECK, MAKE IT OUT TO:

"TOWN OF SHARON - COMMUNITY EDUCATION"

MAIL OR BRING REGISTRATION AND TUITION TO:

Philip Sinrich

Director of Community Education

77 Pond Street

Sharon, Massachusetts 02067-2090