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NAME (FIRST, M.I., LAST):
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ADDRESS:
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TOWN & ZIP CODE:
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HOME PHONE:
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BUSINESS PHONE:
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E-MAIL ADDRESS:
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COURSE NUMBER:
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COURSE NAME:
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STATUS (PLEASE CIRCLE ONE): Adult Non-Resident Sr. Citizen Student Staff |
COURSE FEE:
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DAY(S) CLASS MEETS: Monday Tuesday Wednesday Thursday |
$5 FEE FOR NON-BRAINTREE RESIDENTS:
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CHECK #: BANK NAME: |
AMOUNT ENCLOSED:
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A separate form and a separate check for each course.
Please make checks payable to the Town of Braintree.
Mail to: Braintree Community Continuing Education,
Braintree High School, 128 Town Street, Braintree, MA 02184.