2008 / 2009 Returning Student Registration

Student name: ________________________________________ D.O.B: ___________

Parent's Names: ________________________________________________________

Address: _______________________________________________Zip code________________

Phone #: (_____)_______________ E-mail: ____________________________________

Preferred location and class________________________________

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Please return with first months tuition to:

Brenda Hamilton Coleman, T.C.R.G.

7 Pearl Street

Wakefield, MA 01880

make checks payable to MSOID