REGISTRATION FORM ----------------------- PLEASE PRINT OFF AND MAIL IN BOTTOM PORTION ----------------------- Make checks payable to and mail to: Union #74 Adult and Community Education Superintendent of Schools 767 Main St. 1-A Damariscotta, ME 04543 There is an additional fee of $5.00 per course for residents outside of Union #74. Union #74 services the towns of Bremen, Bristol, Damariscotta, Newcastle, Nobleboro, and South Bristol. We cannot accept phone registrations. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •  • • • •  • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • To complete this registration form please print all information clearly and fill in the prefered class(es) with fee(s) and total fee. Name: __________________________________________________________________ Mailing Address Line 1:______________________________________________________ Mailing Address Line 2:______________________________________________________ Town: ___________________________________________________________________ Phone: (H) ______________________________ (W) ______________________________ E-mail: ___________________________________________________________________ Please be sure to include materials fees where applicable. ------------------------- CLASS ------------------------------------------- FEE 1: _______________________________ ------------ $__________ 2: _______________________________ ------------ $__________ 3: _______________________________ ------------ $__________ 4: _______________________________ ------------ $__________ Non-resident fee: $5 x # of courses enrolled in -------$ __________ ------------------------------------ TOTAL FEE ENCLOSED $ __________ NO course registration confirmation will be sent via phone or mail. You will be contacted only if there are any program changes.