To register, please print and mail in this form to Solidago Continuing Education, 5 Market Square, Suite #106, Amesbury MA 01913 or register by phone at 978-834-3111.

Pre-registration required for all classes. A $50 deposit is needed to hold your place of enrollment. Balance due in full five days prior to start date of class. Cash, check, Visa, and Mastercard accepted. If you cancel your registration with more than ten days notice, you will receive a full refund. Cancellations made ten days or less prior to the class will receive a refund less the $50 deposit.

Name: ________________________________________________________

Address: ______________________________________________________

_____________________________________________________________

Phone: _________________ E-Mail: ____________________________

I would like to register for the following classes:

1) Class Name: ____________________________ on Start Date:______________.

2) Class Name: ____________________________ on Start Date:______________.

3) Class Name: ____________________________ on Start Date:______________.

______ I am sending the $50 deposit and I realize that the balance is due ten days prior to class.

______ I am sending the entire amount of class.

______ I have enclosed a check or money order.

______ Please bill my credit card. (Please circle one) MC Visa

Card # _________________________________________ Expiration: ____________

Signature of card holder: ____________________________________________________________