APPLICATION FOR HAMDEN CLASS ONLY
Parents name __________________________________________________
Parents address __________________________________________________
Tel: ( ) _________- ________________
E-mail address ___________________________________________________
Name of Child (ren) and ages:
______________________________________________________
______________________________________________________
______________________________________________________
Please specify which class you would like:
____________________________________________________
The Fall Semester Price is $105 per 1st child, $52 for second.________________
Total: $___________________
Thank you! Marcia
Please send check to:
Marcia Nelken, 415 Central Ave, New Haven, CT 06515-2258.