Class / Camp Registration
Registrant Name
*
Parent/Guardian Name
Phone
*
Email
*
Street Address
*
Street Address 2
City
*
State
*
Zip
*
HMOA Member
*
Select a Membership Status
Member
Non-Member
Grade
*
Select a Grade
None
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Eighth
Ninth
Tenth
Eleventh
Twelfth
All Grades Completed
Grade completed before class/camp
Age Group
*
Select an Age Group
Under 17
18 to 25
26 to 39
40 to 55
56 to 65
66 and older
Courses
*
Donna Polseno Gropius Workshop - Members: $275 Non-Members: $325
Donna Polseno Gropius Workshop (Teachers) - Members: $250 Non-Members: $250
Donna Polseno Gropius Workshop (Students) - Members: $200 Non-Members: $200
Hold CTRL or Option to select more than one.
