	PENN-TRAFFORD ADULT EDUCATION Volunteers serving the community	www.ptae.org

Registration Form

Instructions: Please complete one registration form and enclose one set of checks (class fee and materials fee if applicable) for each separate class. Make check for the "class fee" (including non-resident fee) payable to Penn-Trafford Adult Education or PTAE unless otherwise noted in the class description. Make the check for the "materials fee" out as indicated in the class description. Mail the completed form and required checks directly to the class representative listed in the class description. IMPORTANT - Please do not send your registration to the Penn-Trafford School District Administration Building.

I hereby waive the Adult Education Program and the Penn-Trafford School District from any responsibility if I should sustain injury during my class.

Name:	_________________________________________________
Address:	_________________________________________________ _________________________________________________
Phone:	_________________________________________________
E-mail:	_________________________________________________
Check one:	Resident ____ Non-Resident ____ HS Student ____
Class:	_________________________________________________
Class begins:	Day of Week: ______________________ Date: _________________ Time: __________________
Fees:	Class Fee: __________________ Non-Resident Fee ($4.00): __________________ Total: __________________ Materials Fee: __________________
Location: ________________________________________________

Attach Payment Here:
Send separate registration forms and checks for each class.
Please make the checks payable to:
Penn-Trafford Adult Education or PTAE for the class fee and the
instructor for any materials fee as described in the class schedule.

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