Library Arts Center--Fall 2010

Class Registration Form

To REGISTER, call (603) 863-3040, email the office at lac@nhvt.net, or return this form to the Library Arts Center.  Upon payment in full, your registration is complete.

**  PLEASE NOTE:  If the class of your choice is full or canceled due to lack of enrollment, you will be notified and entitled to a full refund.  Class tuition is due in full on or before the first day of the class session.  Make-up classes will only be offered when the instructor is unable to teach his/her class.

STUDENT’S NAME: _________________________________________________________________

ADDRESS:_____________________________________________________

_______________________________________________________________

PHONE (H):________________________________    PHONE (W/C):_____________________________

EMAIL:    _______________________________________________

Would you like to be on our mailing list?  ( Y /N )

CLASS TITLES AND TUITION AMOUNTS:

1. __________________________ ____________________________      $_______

2. ______________________________________________________       $_______

3. __________________________ ____________________________      $_______

TOTAL REGISTRATION ENCLOSED   $________________

PLEASE ENCLOSE CHECK MADE OUT TO:   LIBRARY ARTS CENTER.

Library Arts Center Gallery & Studio • 58 N. Main Street   Newport, NH   •    603.863.3040