italian cultural center of western massachusetts, inc. · italian cultural center of western...
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Italian Cultural Center
of
Western Massachusetts, Inc.
56 Margaret St., Springfield, MA 01105 * (413) 784-1492 * www.iccwm.org
Adult Language Registration * (860) 305-1175 * [email protected]
The ICC is a Tax-Exempt 501(c)(3) non-profit organization. Contributions to the ICC are tax deductible.
Adult Italian Language Class Registration (Spring Session 2018)
Please print the following information:
Name:
________________________________________
Primary
Phone:
_____________________________
Street:
________________________________________
Cell
Phone:
_____________________________
City/State/Zip:
________________________________________
What is the best way to notify you of an
emergency change in class schedule?
Email:
_________________________________________ Circle ONE only.
Primary Phone Cell Phone Email
Classes meet from 6 to 8 P.M.
Monday Evenings Monday Evenings Tuesday Evenings
February 26 – April 30
February 26 – May 7
(No Class on March 19)
February 27 – May 8
(No Class on March 20)
Beginner Level I ______ Beginner Level II ______ Intermediate ______
Payment for Tuition + Textbook(s) should be mailed with Registration Form
Tuition: $140 for ICC Members / $160 for Non-Members
(Required) Beginner I Textbook $35 (Nuovo Rete A1–to be provided to student on first day)
(Optional) Beginner I CDROM Supplement $35 (Nuovo Rete A1 Libro Attivo CDROM – to be
provided to student on first day)
(Required) Beginner II Textbook $35 (Nuovo Rete A1–to be provided to student on first day)
(Required) Beginner II Supplemental Reader $10 (Povera Anna – to be provided to student on first day)
(Optional) Beginner II CDROM Supplement $35 (Nuovo Rete A1 Libro Attivo CDROM – to be
provided to student on first day)
(Required) Intermediate Textbook $35 (Nuovo Rete A2 – to be provided to student on first day)
(Optional) CDROM Supplement $35 (Nuovo Rete A2 Libro Attivo CDROM – to be provided to
student on first day)
Deadline for registration is February 19, 2018. Registrations received after that date will be charged a $25.00
late registration fee.
(Please Proceed to Next Page for Payment Instructions)
Italian Cultural Center
of
Western Massachusetts, Inc.
56 Margaret St., Springfield, MA 01105 * (413) 784-1492 * www.iccwm.org
Adult Language Registration * (860) 305-1175 * [email protected]
The ICC is a Tax-Exempt 501(c)(3) non-profit organization. Contributions to the ICC are tax deductible.
Payment: Make your check payable to the Italian Cultural Center and mail it with your registration form
and, if applicable, the new student survey, to ICC at the address shown below. To expedite processing, note
“Attn: AL Registration” on the envelope.
Registration/Withdrawal/Refund Policy: To promote a positive learning environment, ICC accepts a limited
number of students in each class. To reserve a place, the registration form (one for each student) must be
accompanied by the full tuition payment. Once a course is filled and registration for it closed, no refunds will
be made. A course book paid for at the time of registration may be picked up on nights classes are scheduled,
as shown above. ICC reserves the right to make exceptions to this policy as it deems appropriate.
New Students: Kindly take a moment to let us know how you heard about our classes. Specify the source
whenever possible, i.e., Newspaper: ___ ICC Facebook: ___ Friend: ___ Church Bulletin: ___
Television/Radio: ___ ICC Web Site: ___ Other: __________________________________________