Registration form: print and mail to: Return to Course List
The Evergreen Forum
c/o PSRC
_________________________________________________________________________
Name_______________________________________________________
Street_______________________________________________________
City ________________________________________________________
State ___________ Zip ___________________
Phone ____________________________
E-mail ____________________________________
I wish to register for
the following Fall course(s):
c Muses Delight * c Vampires, Werewolves and Witches
c Meet the String Quartet * c USA and Latin America
c Current Events c Goethe's Faust
c Poetry and Prose c Elizabethan Plays
c Rational Energy Policy c Geographical Links
c Women and Public Policy c Don Quixote
c Tribal America c Church and State in Middle Ages
c Americans Abroad c Science Tuesday on Friday
c Museums and More * c Ancient Art
c Jazz
c If I dont get into one of my first choices, my second
choice would be _____________________
c I would like to learn about other PSRC activities
FEES: $50 One
course
$35 Each additional course
Amount enclosed: $_________________
Method of Payment : c Check/Money order c Credit Card
Make check payable to :
PSRC/EF
Charge my : c
Visa c MasterCard
Name on card
_______________________________________
Card number
_____________________________________________
Exp. date
_____________ Signature ______________________________
..
For official
use only: Date:______________________________
Check
#:____________________Initials:_______________________