Name*              

Address*          

City/State/Zip*

Phone*                                                         

Email*               

* = required information

Remarks (500 characters -- future class suggestions welcome!)

Note: by submitting this form your are agreeing to the following statement:
I understand that I will be billed for Adult Enrichment classes in my
next CBE statement and that payment is expected at that time.

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Capitalization matters!

Please click the "Submit" button only once, and be patient while it processes. If you do not see a page showing your submitted information next, your form did not go through. You can try again later, or download the form and send/bring to CBE with your check.