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SPRING 2011 CLASS REGISTRATION FORM

Student name:

Street Address:

City, State, ZIP Code: Phone number: Email:

**If student is under 18 years old**

Parents name: Child’s date of birth:

COURSE 1. 2. 3.

INSTRUCTOR

FEE

$ $ $

Cooking Class

March

March

April

12

19

2

April 9

Welcome to Spring Event with Tappas and Wine on 5/15

    • #

      of classes x $15/20

  • #

    of tickets x $48/$53 =

Contribution to the Scholarship Fund (enter the amount of your donation) MEMBERSHIP FEE (If needed)

$

$ $ $

TOTAL FEES $

Hazleton Art League Membership Categories Junior (under 18) $10 Regular: $25 Family: $50 (1 or 2 adults & all children under 18) Patron: $75 Sustaining: $100 or more

Make all checks payable to:

Hazleton Art League, Inc.

For course descriptions please visit our website www.hazletonsartleague.org

Register in person at the League on Thursday, Feb. 24, at 1-3 pm and 7-9 pm OR Call Dr. Carl Frankel at 570-454-2982 OR Mail completed forms and checks to: Dr. Carl Frankel 994 East Broad St. Hazleton, PA 18201

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