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Patricia Zapata - LaGuardia Community College - CUNY

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4<br />

EASY WAYS TO<br />

REGISTER!<br />

Online:<br />

http://www.peopleware.net/ace<br />

Adult and Continuing Education Registration Form<br />

LAST NAME FIRST NAME MALE/FEMALE<br />

STREET ADDRESS CITY STATE ZIP<br />

DATE OF BIRTH HOME PHONE BUSINESS PHONE<br />

EMAIL<br />

Check which category describes<br />

you best (optional)<br />

SOCIAL SECURITY (optional)<br />

How did you hear about us?<br />

Registration<br />

By phone:<br />

Black non-Hispanic<br />

White non-Hispanic Hispanic<br />

Hispanic<br />

Through our website<br />

Received ACE catalog in the mail<br />

Through friend or neighbor<br />

(718) 482-7244<br />

with payment by MasterCard/<br />

Visa/Discover/American Express.<br />

For English Language classes<br />

call (718) 482-5360.<br />

Asian-Pacific Islander<br />

American Indian/Native Alaskan<br />

Through newspaper<br />

Other<br />

Other<br />

COURSE CODE SEC COURSE TITLE COST<br />

By fax:<br />

(718) 609-2074<br />

with payment by MasterCard/<br />

Visa/Discover/American Express.<br />

In person:<br />

•Tuition fees include registration •<br />

<strong>LaGuardia</strong> <strong>Community</strong> <strong>College</strong>/<strong>CUNY</strong><br />

Room M141<br />

31-10 Thomson Ave<br />

Long Island City, N.Y. 11101<br />

(718) 482-7244<br />

Main Building M141<br />

Monday through Thursday<br />

9 am - 7pm<br />

Fridays 9am-4pm<br />

Saturday 9am-1pm<br />

Fall Winter Spring Summer<br />

(Check one)<br />

Check/Money Order<br />

ACCOUNT NO<br />

EXP DATE<br />

Name of card holder if different from registration<br />

This catalog is printed on paper<br />

that has gone through the Forest<br />

Stewardship Council's (FSC)<br />

chain-of-custody certification.<br />

Even the ink is vegetable-based!<br />

SIGNATURE<br />

Phone: (718)482-7244 • E-Mail: acereg@lagcc.cuny.edu • Fax: (718)609-2074<br />

71

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