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Course Title
Student Information
Name
Address
City
State Zip Code
Home phone
Work phone
E-mail address
Birthdate
Credit Card Number
Expiration Date Code
Card Holder's Name
Signature (for credit card users only)
MSAD #40 Adult Education does not send confirmation cards.
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Make check or money order payable to: MSAD 40. Mail registration and payment to MSAD 40 Adult Education, 320 Manktown Road, Waldoboro, ME 04572. Upon receipt of registration and payment, you are enrolled. No confirmation will be sent, although you may call 832-5205 to check on your course status.
Date_______________Cash ________Check_______CC_______
Date_______________Cash ________Check_______CC_______
Make check or money order payable to: MSAD 40. Mail registration and payment to MSAD 40 Adult Education, 320 Manktown Road, Waldoboro, ME 04572. Upon receipt of registration and payment, you are enrolled. No confirmation will be sent, although you may call 832-5205 to check on your course status.
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