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Name

Course No.



     If you are signing up for Class #504 (Body Sculpting-3 Terms)
     or Class #713 (Egg Decorating-2 Classes),
     please enter the course numbers you would like here.

Course Name

Fee $

Address

City

Zip Code

Home Phone (XXX-XXX-XXXX)

Other Phone (XXX-XXX-XXXX)

E-mail Address



This information is used solely for the purpose of brochure mailings. We will not give your information to any third parties.




Please pay by mail or by coming into the office within 5 days or you will lose your registration!

Office Address: Community Education
525 Seventh St. N.E.
North Canton, OH 44720


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