Spring Summer 2020 Classes

Registration Form

First Name

Last Name

Address

City

State

Zip

Phone Number

Email

Second Registrant’s Name

Phone Number

Email

Course Name

Course Code

Total Course Fee $

I would like to support The Center’s on-going community programs, enclosed is my tax- deductible donation:

$

Total $

Payment Methods Credit Card n Visa n Mastercard

Name as it appears on Card

Card Number

Security Code

Signature

Expiration date

Check n Please make checks payable to Center for Continuing Education and mail with this form to 1000 West Boston Post Road, Mamaroneck, NY 10543

. 24 .