Registration form
| Class #1 | Day/Time | ||
| ___________________________________________________________ | |||
| Class #2 | Day/Time | ||
| ________________________________ ___________________________ | |||
| Class #3 | Day/Time | ||
| ___________________________________________________________ | |||
| First Name | Last Name | ||
| ___________________________________________________________ | |||
| Street Address | |||
| ___________________________________________________________ | |||
| City | State | Zip | |
| __________________________________________________________ | |||
| Phone | |||
| ___________________________________________________________ | |||
| Email—–Please print clearly | |||
| ___________________________________________________________ | |||
Please include a check with your registration made out to: MCTC SENIORNET
The cost for a 4 week class is $25.00
We will be unable to provide refunds if you do not cancel at least 7 days prior to the beginning of the class.
Mail application to:
Gladys Green Seniornet Program
MCTC
1403 Harmon Place
Minneapolis, MN 55403
Last update 10/13/2007