MMS Enrichment Program Registration - Print and hand in to Main Office. ---->
               Due September 8th -   You may register late for courses with openings

 Student’s Name: _______________________________________________________________

 Homeroom Teacher: ________________________________________________Grade: ______

 Address: ______________________________________________________________________

Parent/Guardian: __________________________________________________

 Home Phone: ______________________Day Phone:  ___________________

 Email Address _________________________________________________________________

Enrichment: $30 / 6 wks/course     Service Courses: No Fee
checks payable to : MMS Enrichment Program. Please sign up for only ONE cooking class
                  * Contact Guidance or the Program Coordinator for sliding fee application

  First Choice Second Choice
Monday    
Tuesday    
Wednesday    
Thursday    
Friday    

Bus (NO FEE):        ð Mon   ð Tues.    ð Wed.   ð Thurs.
Parent Volunteers: ð aide courses. ð Sign In 2:00 - 3:00pm ð drivers
Permission for school record access:  ð yes ð no
Healthy Kids  Free Lunch ð  reduced Lunch ð

Course Fee(s): $ _____________________
Materials fee: $ _____________________
Access Sliding Fee Donation: $ _____________________
Total: $ _____________________
Weekly Enrichment or Extended Day  ____ (please check)

milfordnh.com/enrichment/registration.htm