Garden Master Classes

Registration
(Please print)
UCONN GARDEN MASTER CLASSES
UConn Home and Garden Education Center
1380 Storrs Road, Unit 4115
Storrs, CT 06269-4115
SPRING 2012 R E G I S T R A T I O N F O R M
_________________________________________ _______________________________
Name
Day Phone
__________________________________________ _______________________________
Street Address
Evening Phone
__________________________________________
City/Town State Zip Code
__________________________________________
E-mail address
Registration confirmation is via email wherever possible. If you do not have email, please
ensure that we have a telephone number where we can reach you.
Payment - Make check or money order payable to “UConn.” Check # ________
Are you a Master Gardener? Yes/ No If Yes, year certified: 19_____ or 20_____
In which county? ______________________________________
❑ Please check this box if this is the first time you’ve enrolled for Advanced Master Classes.
Please fill out below with the course number (S12/XX), title and cost. Mail your completed
registration and payment to:
UConn Home & Garden Education Center/AMG Classes
1380 Storrs Road, Unit 4115
Storrs, CT 06269-4115
Registration confirmation is via email wherever possible. If you do not have email,
please ensure that we have a telephone number where we can reach you.
Class # ______ Title: _____________________________ $_______
Class # ______ Title: _____________________________ $_______
Class # ______ Title: _____________________________ $_______
Class # ______ Title: _____________________________ $_______
Class # ______ Title: _____________________________ $_______
Class # ______ Title: _____________________________ $_______
Class # ______ Title: _____________________________ $_______
Class # ______ Title: _____________________________ $_______
Total: $______
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The University of Connecticut is an equal opportunity employer and program provider.