COURSE REGISTRATION FORM

To register by mail

Print out this page, fill it out, and mail with payment to: Lancaster County Historical Society, 230 N. President Ave., Lancaster, PA 17603.

Please sign me up for the following courses!

Name of class(es):

1. _______________________________________________        Date: __________

2. _______________________________________________        Date: __________

3. _______________________________________________        Date: __________

4. _______________________________________________        Date: __________

5. _______________________________________________        Date: __________

6. _______________________________________________        Date: __________

Name:__________________________________________________________________________

Address: _______________________________________________________________________

City: ___________________________________       State: _______      Zip:  _____________

Phone: ____________________________    Email:____________________________________

Cost: _____ class(es) x    $20 member   /   $25 nonmember    =   $_________

                                                 (circle one)