POLISH CULTURAL FOUNDATION

CLARK, NEW JERSEY, USA

Adult Studies

  REGISTRATION FORM

EVENING STUDIES PROGRAM – SPRING 2010

 

Please print information. Payments must be made in full by first class. Sorry no refunds. 

NAME (first and last in full)

(Imię  i nazwisko): ________________________________________________________

ADDRESS: _____________________________________________________________

PHONE (Nr telefonu): (______)____________________ 

COURSE TITLE

(Nazwa kursu): __________________________________________________________

COST OF COURSE

(Koszt kursu): $ ____________________

Membership dues, if not already paid - $ 10.00 

                                                                       TOTAL (razem): _______________ 

Please make all check payable to the POLISH CULTURAL FOUNDATION, 177 Broadway, Clark, NJ 07066. The Polish Cultural Foundation is a non profit organization that subsidizes the Studies Program and all of its activities. It relies on support from Membership dues and from public donations which it gratefully acknowledges.

                                   

 

  

 

 

 

 

 

 

 

 

REGISTRATION FORM

EVENING STUDIES PROGRAM – SPRING 2010

 

Please print information. Payments must be made in full by first class. Sorry no refunds.

 

NAME (first and last in full)

(Imię  i nazwisko): ________________________________________________________

ADDRESS: _____________________________________________________________

PHONE (Nr telefonu): (______)___________________

 

COURSE TITLE

(Nazwa kursu): __________________________________________________________

COST OF COURSE

(Koszt kursu): $ ____________________

Membership dues, if not already paid - $ 10.00 

                                                                       TOTAL (razem): _______________

 

Please make all check payable to the POLISH CULTURAL FOUNDATION, 177 Broadway, Clark, NJ 07066. The Polish Cultural Foundation is a non profit organization that subsidizes the Studies Program and all of its activities. It relies on support from Membership dues and from public donations which it gratefully acknowledges.