CLASS REGISTRATION FORM

CLASS DESCRIPTIONS

Print and return this registration form with your payment to:

The Dante Alighieri Society of Santa Cruz
P.O. Box 4253
Santa Cruz, CA 95063-4253

Date _______________________

Ms./Mrs./Mr./Dr.___________________________________________________

Address___________________________________________________________

City _____________________________________________ Zip____________

Tel. # (h) _______________________ Tel. # (w) _________________________

E-mail___________________________________________________________

Note: Are you a Dante Alighieri Society member? __Yes   __No
__I'm joining today and including my membership fee in my payment
(If you join today, you will be eligible for the member's rate for the courses.)

__Beginning Italian
__$175 member     __$200 non-member

__Italian Conversation
__$175 member     __$200 non-member

YEARLY MEMBERSHIP RATES
If you would like to join, please pick a membership category:

__ General $30
__ Senior (62+) $25
__ Full time student $10
__ Family $50
__ Life time membership $500

AMOUNT ENCLOSED $ ________________
(Make checks payable to Dante Alighieri Society of Santa Cruz)

How did you hear about us? __________________________________

Are you interested in becoming a volunteer for Dante Santa Cruz? If so, check one of the following:
______OFFICE TASKS (iMac) ____PUBLICITY _____POSTER DESIGN ______EVENT HOSPITALITY