Middle School University 2014 Registration Form Middle School ...

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Call (608)355-5220 to register with your credit card. 3. Fax your registration form with credit card information to: (60
Middle School University 2014 Registration Form

Middle School University 2014 Registration Form

Name_______________________________________________

Name_______________________________________________

Address_____________________________________________

Address_____________________________________________

City/St/Zip___________________________________________

City/St/Zip___________________________________________

Day Phone_____________________ Evening_______________

Day Phone_____________________ Evening_______________

Email_______________________________________________

Email_______________________________________________

Registration deadline: June 2, 2014

Class size is limited

Registration deadline: June 2, 2014

Class size is limited

Please Indicate Your Top 4 Choices

Please Indicate Your Top 4 Choices

Number in Order of Preference (1,2,3,4):

Number in Order of Preference (1,2,3,4):

Chemistry in the “Lime Light”

Chemistry in the “Lime Light”

National Treasure – Baraboo: Historical Treasure Hunt

National Treasure – Baraboo: Historical Treasure Hunt

Presidential Elections in American History

Presidential Elections in American History

Doctor Who in Film and Fiction

Doctor Who in Film and Fiction

Baraboo Rocks!

Baraboo Rocks!

Exploring Creatures Big and Small

Exploring Creatures Big and Small

From the Page to the Stage -Workshop on Play Production

From the Page to the Stage -Workshop on Play Production

SELECT :

_____ AM only 9:00AM-Noon ($89.00) _____ PM only 1:00-4:00PM

($89.00)

SELECT :

$89.00 for a half day * (1) 3-hour class Mon-Fri

_____ PM only 1:00-4:00PM

($89.00)

_____ FULL Day 9:00AM-4:00PM ($150.00)

_____ FULL Day 9:00AM-4:00PM ($150.00) CLASS FEE:

_____ AM only 9:00AM-Noon ($89.00)

CLASS FEE:

$89.00 for a half day * (1) 3-hour class Mon-Fri

$150.00 for a full day *(2) 3-hour classes Mon-Fri

$150.00 for a full day *(2) 3-hour classes Mon-Fri

Scholarships are available for qualified individuals

Scholarships are available for qualified individuals

TO REGISTER:

TO REGISTER:

1. Make checks payable to: UW-Baraboo/Sauk County, and mail to: Continuing Education Office, 1006 Connie Road, Baraboo, WI 53913

1. Make checks payable to: UW-Baraboo/Sauk County, and mail to: Continuing Education Office, 1006 Connie Road, Baraboo, WI 53913

2. Call (608)355-5220 to register with your credit card

2. Call (608)355-5220 to register with your credit card

3. Fax your registration form with credit card information to: (608)355-5290

3. Fax your registration form with credit card information to: (608)355-5290