Admiral Peary AVTS
Office of Lifelong Learning
Registration Form

 

Name:__________________________________________________

Address:_________________________________________________

City:______________________________ Zip:___________________

E-mail Address:___________________________________________

Day Phone Number:________________________________________

Evening Phone Number:_____________________________________

 

Course Selection:__________________________________________

Course Selection:__________________________________________

Cost:___________________________________________________

Would you like to receive updates from us?____________

Make Checks Payable to Admiral Peary AVTS.
Total Registration Fee Must Accompany This Form.

Mail Registration Form to:

Admiral Peary AVTS
Office of Lifelong Learning
948 Ben Franklin Hwy
Ebensburg, PA 15931