the brochure. - Southington Public Schools

Fall 2013 Enrichment Course Registration FormName: ______________________________________________________________________Address:___________________________________________________________________Town/Zip: ___________________________________________________________________Home Phone: __________________________Cell Phone: ____________________________E:mail: ______________________________________________________________________Course Name: _______________________________________Course Code: _____________Night (s) of Course: ___Monday ___Tuesday ___Wednesday ___ThursdayCourse Fee: ___________________________________________________*There needs to be one registration form for each course enrolled. More registration forms are availableonline at www.southingtonschools.orgNote: You are automatically enrolled unless otherwise notified.MAIL BY: August 30, 2013 after this date in-person registration will be accepted between 6-8 p.m.Make check out to: SOUTHINGTON CONTINUING EDUCATIONMail to: Southington High SchoolAttn: Southington Continuing Education720 Pleasant Street, Southington, CT 06489DateFor Office Use OnlyCheck of Cash Amt.Southington Adult & Continuing EducationSouthington High School720 Pleasant StreetSouthington, CT 06489860-628-3229, Extension 33324