ADULT EDUCATION REGISTRATION FORM -(Print Page)

Name: Mr., Mrs., Ms., Dr.                                                          FAX TO: 214-515-6578

___________________________________________________________________________

Address:____________________________________________________________________

City: ______________________________________ State: ____________ Zip: ___________

Email: _____________________________________________________________________

Home Phone: _________________________  Mobile Phone: _______________________

Subtotal: $_________
Membership Fees (Join today and receive the Member class price!): $_________
Total: $_________
 

If you are already a member, please give us your membership number: __________________________

Check Enclosed    or AMEX Discover     MC   Visa

Card #: _______________________________________ Expiration:_________________

Signature:______________________________________ CSV**: ___________________

Cancellations, subject to a 5% or $5 minimum processing fee, can be made up to five (5) business days prior to the class. No Refunds for cancellations made within five business days prior to the class. Please duplicate this form to share with friends.

*Become a member of the Arboretum and receive the member price on all classes. Fill in the "Membership Fees" box and enclose payment of $60 for Member, $95 for Family, $200 for Sustaining. For more information on membership please call 214-515-6548 or click here to visit our membership page.

** 3 digit code on the back of the credit card. 4 digit code on the front of American Express cards.