Italian School for Children - Course Registration

Member Name:                                                                        Date:

Address:

Phone: (W)                                                  (H)

e-mail:

Name of Child:                                                          Age:        Course:

Name of Child:                                                          Age:        Course:

Name of Child:                                                          Age:        Course:

How did you hear about the school?

   I have a current Family Membership with the Dante Alighieri Society.

   I do not have a current Family Membership with the Dante Alighieri Society.
       I am enclosing a check for $100.00 for the Family Membership.

Signature_______________________________________

 
Please print out this form, fill it and send it with a check made payable to:

Dante Alighieri Society of Massachusetts
Saturday Children's School Registration
41 Hampshire St.
Cambridge, MA 02139