47 Course fees must be paid in full at time of registration. We accept cash, check, money order, Discover, VISA, MasterCard, or American Express. Checks payable to “Assabet After Dark” or “AAD” It is important to provide a current email address when establishing your account to receive your email registration confirmation. Online: AssabetAfterDark.com Mail: Complete the registration form and mail it along with your payment to: Assabet Valley Regional H. S. Assabet After Dark 215 Fitchburg Street, Marlborough, MA 01752-1288 Phone: (508) 263-9651 In Person: Visit us during office hours. There are Several Ways to Register with us... REGISTRATION FORM Senior Discount ------------------------------------------------------- Minus 10% - __________ if applicable: Date of Birth _____/_____/________ Assabet After Dark reserves the right to cancel classes with insufficient enrollment and to make changes in instructors or class schedules due to unforeseen circumstances. Name: __________________________________________________ Address: ________________________________________________ City/State/Zip: ___________________________________________ Phone (Home): ________________________________________ (Cell): ____________________________________________ Email ___________________________________________________ Date of Birth ______/______/______ Call the office for first time Senior Citizen registrations! r Enclosed is my check. Check #____________ r Discover r MasterCard r VISA r American Express Card No. ________________________________ Expiration Date: __________ Security Code: ______ Signature: _______________________________ Please read our refund / withdrawal policy carefully. Course # Course Title Fee 1 2 3 TOTAL_______________ Make Checks Payable to “Assabet After Dark” or “AAD” REGISTER NOW!!