NAUGATUCK ADULT and CONTINUING EDUCATION
543 Rubber Ave.
Naugatuck, CT  06770
U.S.A.

Table of Contents  ~  Home

---

REGISTRATION INFORMATION
 

 
 

TODAY’S CHOICE FOR TOMORROW’S WORLD

INSIDE:

• PERSONAL ENRICHMENT
• ENGLISH-AS-A-SECOND LANGUAGE
• HIGH SCHOOL DIPLOMA PROGRAM
• PROFESSIONAL DEVELOPMENT
• COMPUTER CENTER
• FUN & EXERCISE

My interest is in:

----------------------------------------------------------------------------

I would like to teach a class. My course proposal is:

My name:____________________________________________________________________

Address:____________________________________________________________________

Town: __________________________________             Zip:_________

Telephone #:_____________________________             Best time to contact:_______________
 
 

PHONE-IN     (Easiest Way) Register on the telephone with either a MasterCard orVisa.  Call: (203) 720-5282	WALK-IN     (Most Personal Way) Register in person by coming to the Continuing Education Office located in Room C109 at the high school.
FAX-IN     (High-Tech Way) Fax us your completed registration form including your credit card number and expiration date.  Call: (203) 720-5281	MAIL-IN     (Postal Service Way) Complete the registration form and mail it to the Continuing Education Office.

Name:_______________________________________________________Home Phone:_______________________

Street:_______________________________________________________Day Phone:________________________

Town:_________________________________        Zip:_______________

COURSE TITLE COURSE FEE

_______________________________________________________________________________________________________________

Payment by:    [   ] Cash    [   ] Check   [   ] MasterCard   [   ] VISA

Authorized Signature_______________________________________________Charge Acct. #___________________________________

Expiration Date________________________________
 
 

Name:_______________________________________________________Home Phone:_______________________

Street:_______________________________________________________Day Phone:________________________

Town:_________________________________        Zip:_______________

COURSE TITLE COURSE FEE

_______________________________________________________________________________________________________________

Payment by:    [   ] Cash    [   ] Check   [   ] MasterCard   [   ] VISA

Authorized Signature_______________________________________________Charge Acct. #___________________________________

Expiration Date________________________________
 

Back