Public Programs General Inquiry Form

Please complete the form below.


What are you interested in?

Adult/ High School

Family/ Children

Teacher Program

Community Programs

	Mr. Miss Mrs. Ms.
Name
Address
City
State
Zip
Day Phone
Business Phone
Email
How did you find out about Continuing Education Programs?
	Internet
(What site?)
	Catalogue
(How did you get it?)
	Radio Ad
(What station?)
What is your favorite station?
	Newspaper/Magazine Ad
(Which one?)
	Word of mouth
(Who?)
	Other
(Please specify)
Have you taken a class here before?	YesNo
Are you an Academy alumnus?	YesNo
If yes, which program/year?
Best way to be contacted	Day Phone   Business Phone   Email