# 2 Mail-In Registration Instructions
ENFIELD ADULT EDUCATION WINTER / SPRING 2023 REGISTRATION FORM
Please print neatly . Mail to Enfield Adult Education , 124 North Maple Street , Enfield , CT 06082
Make check or money order out to : The Town of Enfield . Do not send cash . All residents my register beginning November 21 , 2022 . Please indicate names if more than one person is registering .
Please make extra copies if needed .
You will only be notified if a class is canceled or filled . No Confirmation Will Be Sent . COURSES FILL QUICKLY ! REGISTER NOW !
Name _______________________________ Name _______________________________ Address :_____________________________ Address : ____________________________
Town & Zip : ________________________ Town & Zip :_________________________
( )
( )
Home Phone # _______________________ Home Phone # _______________________
Work Phone # ________________________ ( )
Work Phone # ________________________
( ) ( ) ( )
Cell Phone # _________________________ Cell Phone # _________________________
Email : ______________________________ Email : ______________________________ Are you over age 65 ? ______ yes _____ no
New
Are you over age 65 ? ______ yes _____ no
Residents of East Granby , Enfield , Granby , Somers , Suffield and Windor Locks pay the stated fee . Residents of all other towns pay the stated fee plus a $ 10 surcharge per class . Senior citizens ( aged 65 +) pay 50 % of the fee , except where stated , and do not pay the surcharge .
Course Name - ( Person enrolled if Fee $ 10 Surcharge Total multiple registration ) for Non-East Granby , Enfield , Granby , Somers & Suffield and Windsor Locks Residents Per Class
___________________________________ $__________ $__________ $____________ ___________________________________ $__________ $__________ $____________ ___________________________________ $__________ $__________ $____________
Total Enclosed
$ ____________
Snow policy : If Enfield Public Schools are closed , Enfield Adult Education classes are canceled . Call the school closing hotline at ( 860 ) 253-5170 . Please retain for your records . No written confirmation will be sent .
Registered for : _______________________ Registered for : _________________________ Date / time of class :____________________
Date / time of class :______________________ Location / Room : _____________________ Location / Room : _______________________ ALL MANDATED PROGRAMS ARE FREE • WINTER / SPRING 2023 • EAE • 23