Community Education - current class catalogs Families - Fall 2014

registration forms ECFE FAMILY INFORMATION (Please print legibly) Family last name____________________________________________________________________________________________________________________ Home or primary phone _____________________________________________________________________________________________________________ Parent(s) attending ________________________________________________________ ________________________________________________________ First Last First Last ECFE, 2727 Ferry St., ECFE Mail to:MN 55303 •N.763-506-1275 Anoka, Work phone _____________________________________________________________ ________________________________________________________ Cell phone ______________________________________________________________ ________________________________________________________ Address_________________________________________________ City____________________ Zip code_________________________________________ Email address_______________________________________________________ r Yes, I would like to receive ECFE newsletters and other class info by email. All children attending including infants: Name________________________________________________________________________________ Birthdate___________________________________ Name________________________________________________________________________________ Birthdate___________________________________ Name________________________________________________________________________________ Birthdate___________________________________ Do you or your child have health, behavior or other special needs? Please explain______________________________________________________________________________________________________________________ ECFE CLASS REGISTRATION - Registration also accepted online at www.discovercommunityed.com Class number Location r VISA r MasterCard r Discover Mail to: Community Schools • 763-506-1260 See page 36 for specific addresses of class locations CS Class Title_____________________ Exp. Date______________ Fee 1st choice class fee $______________ Card No. __ __ __ __ –__ __ __ __ –__ __ __ __ – __ __ __ __ Signature___________________________________________________________ Parent(s) Name Day 1st Choice Alternate Choice r Cash r Check No._______________ (payable to ECFE) Fees can be adjusted due to inability to pay. I can pay $______________ r Cash r Check No. ___________ (payable to AH Dist #11 Comm. Ed.) Home phone_________________Work/Cell __________________ r VISA r MasterCard r Discover Address_________________________________________________ Card No. __ __ __ __ –__ __ __ __ –__ __ __ __ – __ __ __ __ City______________________________ Zip____________________ Exp. Date_________ Signature__________________________ Email address____________________________________________ Course No.___________________ Class title____________________Fee $___________ Location_______________ Day/Time____________ Course No.___________________ Class title____________________Fee $___________ Location_______________ Day/Time____________ Course No.___________________ Class title____________________Fee $___________ Location_______________ Day/Time____________ *Please complete and mail or drop off a seperate form and payment for each class location. Total payment enclosed $__________________________________ Child last name____________________________________ First name __________________________________ Birthdate_________________ Does your child have health, behavior or other special needs?_______________________________________________________________ www.discovercommunityed.com 39

Community Education - current class catalogs Families - Fall 2014 | Page 39