REGISTRATION FORMS

Print and Return registration form to:  Secaucus Community Education, Paul Amico Athletic & Education Complex, 11 Mill Ridge Road, P.O. Box 1466, Secaucus, NJ 07096 – Tel: 201-974-2027 or 201-974-2028          Make all checks and money orders payable to Secaucus Board of Education     A separate check or money order is required for each course

 

CLASS TITLE: _________________________________________________ COURSE #: ____________

 

DAY: ___________________ TIME: _______________   FEE: _____________ CHECK #: __________

 

NAME: ______________________________________________________________________________

 

ADDRESS: ___________________________________________________________________________

 

CITY: ______________________________________STATE: ___________ZIP: _____________________

 

HOME #: ____________________WORK #: ____________________CELL #: ___________________

 

F  Please make separate check or money order for each course, payable to Secaucus Board of Education and indicate course on each check. 

 

CLASS TITLE: _________________________________________________ COURSE #: ____________

 

DAY: ___________________ TIME: _______________   FEE: _____________ CHECK #: __________

 

NAME: ______________________________________________________________________________

 

ADDRESS: ___________________________________________________________________________

 

CITY: ______________________________________STATE: ___________ZIP: _____________________

 

HOME #: ____________________WORK #: ____________________CELL #: ___________________

 

F  Please make separate check or money order for each course, payable to Secaucus Board of Education and indicate course on each check. 

 

CLASS TITLE: _________________________________________________ COURSE #: ____________

 

DAY: ___________________ TIME: _______________   FEE: _____________ CHECK #: __________

 

NAME: ______________________________________________________________________________

 

ADDRESS: ___________________________________________________________________________

 

CITY: ______________________________________STATE: ___________ZIP: _____________________

 

HOME #: ____________________WORK #: ____________________CELL #: ___________________

 

F  Please make separate check or money order for each course, payable to Secaucus Board of Education and indicate course on each check.