FALL 2015 MILE REGISTRATION FORM
REQUIRED OFMEMBERS
Name Tag:______MxCC ID#:______
(Members-See Name Tag)
Name : ______
Address: ______
City: ______ZIP:______
Phone: ______E-Mail:______
CHECK ONLY PROGRAMS YOU EXPECT TO ATTEND
√ 3628 CRN# for Office UseO 3629 Joe FireCrow Music Perf.
O 3630 CT Gypsies
O 3631 12th Century Murder
O 3632 Opera: Marriage of Figaro
O 3633 Book Disc.: Elephant Co.
O 3634 Women’s Suffrage Movement
O 3635 Long Isl. Sound Landscaping
O 3636 Humanity’s Growing Threats
O 3637 New Zealand
O 3638 Estate Planning
O 3639 Art: Paint a Wine Glass ($20)
O 3640 Introduction to Genealogy
O 3641 U S Foreign Policy forE.Asia
O 3642 Mary Oliver Poetry
O 3643 Fabric Flower Fun ($2)
O 3644 Living with Soviets..Antarctica
O 3645 An Ethiopian Experience
O 3646 Tour – Old Wethersfield
O 3647 Mongolia
O 3648 Iceland / O 3649 MILE’s Road Schlr Trips
O 3650 Plan for the Moon
O 3651Toxic Chemicals
O 3652 Cuba, Now & Then
O 3653 Great Decisions
O 3654 Book Disc.: Reckless
O 3655 Your Brain Power
O 3656 Storytelling for Adults
O 3657 The Great War at 100
O 3658 Moderate Islam
O 3659 Basic Feng Shui
O 3660 Protect Your Assets
O 3661 Wisdom of the Greeks
O 3662 CT’s Deadly Tornados
O 3663 CT Earthquakes?
O 3664 Ethics & the Amer. Poem
O 3665 Rock 'n' Roll History
O 3666 The Mariel Boatlift
O 3667 Pegmatite Rock
Trip: 9/11 Memorial, NYC: October 20 or 22. See Form to Register
Birth Date______New Member Only / Required of New Members Only
Soc. Sec.# ______
Mail to:
MILE
Middlesex Community College
100 Training Hill Road
Middletown CT 06457 / Member Annual Dues $60
(Opt.: 2015 Great Decisions Book $10)
Method of Payment (Check One)
O Check payable to MxCC#______
Charge: O Visa O MasterCard
Account #______
Expiration Date ______
FALL 2015 MILE REGISTRATION FORM
REQUIRED OFMEMBERS
Name Tag:______MxCC ID#:______
(Members-See Name Tag)
Name : ______
Address: ______
City: ______ZIP:______
Phone: ______E-Mail:______
CHECK ONLY PROGRAMS YOU EXPECT TO ATTEND
√ 3628 CRN# for Office UseO 3629 Joe FireCrow Music Perf.
O 3630 CT Gypsies
O 3631 12th Century Murder
O 3632 Opera: Marriage of Figaro
O 3633 Book Disc.: Elephant Co.
O 3634 Women’s Suffrage Movement
O 3635 Long Isl. Sound Landscaping
O 3636 Humanity’s Growing Threats
O 3637 New Zealand
O 3638 Estate Planning
O 3639 Art: Paint a Wine Glass ($20)
O 3640 Introduction to Genealogy
O 3641 U S Foreign Policy forE.Asia
O 3642 Mary Oliver Poetry
O 3643 Fabric Flower Fun ($2)
O 3644 Living with Soviets..Antarctica
O 3645 An Ethiopian Experience
O 3646 Tour – Old Wethersfield
O 3647 Mongolia
O 3648 Iceland / O 3649 MILE’s Road SchlrTrips
O 3650 Plan for the Moon
O 3651Toxic Chemicals
O 3652 Cuba, Now & Then
O 3653 Great Decisions
O 3654 Book Disc.: Reckless
O 3655 Your Brain Power
O 3656 Storytelling for Adults
O 3657 The Great War at 100
O 3658 Moderate Islam
O 3659 Basic Feng Shui
O 3660 Protect Your Assets
O 3661 Wisdom of the Greeks
O 3662 CT’s Deadly Tornados
O 3663 CT Earthquakes?
O 3664 Ethics & the Amer. Poem
O 3665 Rock 'n' Roll History
O 3666 The Mariel Boatlift
O 3667 Pegmatite Rock
Trip: 9/11 Memorial, NYC: October 20 or 22. See Form to Register
Birth Date______New Member Only / Required of New Members Only
Soc. Sec.# ______
Mail to:
MILE
Middlesex Community College
100 Training Hill Road
Middletown CT 06457 / Member Annual Dues $60
(Opt.: 2015 Great Decisions Book $10)
Method of Payment (Check One)
O Check payable to MxCC#______
Charge: O Visa O MasterCard
Account #______
Expiration Date ______