2010 Sign-up Form

Please send the payment before filling out this form.

Student's name and age or grade (or Students' names and ages or grades):
If the student is an adult, just write "adult" instead of the age.
If there is more than one student and they are taking different classes, also include the courses each one will be taking.

Total number of students:

Parent's name (or your name if the student is an adult):
First Last

Address (you only need to put down the city and state):

Your E-mail address:
If the student has his own e-mail address, be sure to give your e-mail address here and not the student's.

2 Optional questions:

What kind of Internet connection do you have?
Dial-up modem
Broadband (cable, dsl, fiber)
Not sure

Where did you find out about the classes here?

Check the course(s) you want to use:


Logic

Medieval History
Religion: The Mass
African/Pacific Geography

Math: Fractions

Ancient History
Bible History
U.S. History
Science History
Science Projects
European & Asian Geography
American Geography (N. & S. America)
Church Latin
(Biblical) Greek grammar Music theory

Creative Writing

     Number of children taking Creative Writing:

10-week courses:

Greek Alphabet
Hebrew Alphabet

Art Projects
Religion:Compline

Amount due for the first half of the year: $.00
Amount due if you'd like to pay for the full year now: $.00

Have you sent the payment yet?
No, it has not been sent yet.
By cash or check: Check number
By Credit Card/PayPal

Amount that was sent: $.00

Write to me at rmkrc lphrc.org if you have any trouble with this form.

Privacy policy: This is for my record-keeping. No information collected here will ever be sold or given to any third party.