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4<br />
EASY WAYS TO<br />
REGISTER!<br />
Online:<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 />
SOCIAL SECURITY (optional)<br />
www.laguardia.edu/acereg/<br />
By phone:<br />
(718) 482-7244<br />
For English Language classes<br />
call (718) 482-5360.<br />
Check which category describes<br />
you best (optional)<br />
Black non-Hispanic<br />
White non-Hispanic<br />
Hispanic<br />
Asian-Pacific Islander<br />
American Indian/Native Alaskan<br />
Other<br />
How did you hear about us?<br />
Through our website<br />
Received ACE catalog in the mail<br />
Through friend or neighbor<br />
Through newspaper<br />
Other<br />
COURSE CODE SEC COURSE TITLE COST<br />
How to Register<br />
By fax:<br />
(718) 609-2006<br />
In person:<br />
LaGuardia Community College/CUNY<br />
Room M-143<br />
31-10 Thomson Ave<br />
Long Island City, NY 11101<br />
(718) 482-7244<br />
M-Building, Room M-143<br />
Monday through Thursday<br />
8:30 am - 6:30 pm<br />
Fridays 8:30 am - 3:30 pm<br />
Saturday 8:30 am - 12:30 pm<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 • www.laguardia.edu/acereg/ 43