Click here for the original
MSWord document
Click here for the HTML form view ready to print
The
Florence Melton Adult Mini-School
Registration Form
Name:
Address:
City:
Zip:
Daytime Phone:
Evening Phone:
Fax:
E-mail:
Please check your preference. If you have a first and second choice, please
indicate. Evergreen schedule will be based on student preference.
Denver Campus
__Monday evenings __Thursday mornings
__Tuesday mornings __Thursday evenings
__Evergreen Campus
__Tuesday mornings __Tuesday evenings
__Boulder/Menorah Campus
__Fort Collins Campus
Payment Information
____$495 enclosed.
____ I have already spoken to Maggie Miller about arrangements for financial
assistance. ____ is enclosed.
Payment by
__check (make checks payable to CAJE)
__credit card __ MC __Visa
Card number: __________________________________
Expiration date:____-_____
Signature:______________________________________
Return to:
Colorado Agency for Jewish Education
Attn: FMAMS
300 South Dahlia Street, Suite 101
Denver, CO 80246
Fax (303) 321-5436
For more information call
Maggie Miller at 303-321-3191 ext. 17
