Fall Registration 2012

MERCAZ FALL REGISTRATION 2012

Your Name:	*
Phone:	*
Grade:	*
Parent Email Address:
Email Address:	*
Synagogue:

6:30 - 7:25. Choose your 1st and 2nd class choices below.

Classes are filled on a first come first serve basis. Register NOW to ensure placement in your preferred classes.

Note: Video Film Making and Paint Your Jewish World meets both hours (6:30 - 8:30 with break)

6:30pm 1st Choice:	*
6:30pm 2nd Choice:	*

7:35pm

List a first and second class choice for 7:35. Classes are filled on a first come first serve basis. Register NOW to ensure placement in your preferred classes.

7:35pm. 1st Choice:	*
7:35pm. 2nd Choice:	*
Optional: List 1 friend you would like to be in class with:
I would prefer to:	*

(Fields marked with * are required)

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