REGISTRATION FORM - PRINT VERSION

Fall 2010 / Winter 2011
Registration for the fall begins August 2
Registration for the winter begins November 1



INCLUDE YOUR PAYMENT AND RETURN TO:
The Visual Arts Centre
350 Victoria, Montreal (QC) H3Z 2N4
Tel: (514) 488-9558 | Fax: (514) 488-7075
1.      
Course/Workshop ________________________    
Day/Time ________________________    
Teacher ________________________ COST: ________________________
       
2.      
Course/Workshop ________________________    
Day/Time ________________________    
Teacher ________________________ COST: ________________________
       
   
Annual Registration Fee (single=$20; family=$25) ________________________
Sub-total: ________________________
(for 15 year-olds and over) GST 5% ________________________
Sub-total: ________________________
(use above sub-total) PST 7.5% ________________________
TOTAL: ________________________
   
   
Family Name ________________________ First Name  
Address ________________________________________________
City ________________________ Province ________________________
Postal Code ________________________    
Tel. (home): ________________________ Tel. (other): ________________________
       
YOUTH COURSES
Parent's Name ________________________  Child's Birthday ________________________
       
PAYMENT METHOD  
Cheque ________________________    
 
VISA/MASTERCARD
Card Number ________________________ Expiry Date ________________________
Signature ________________________