Winter 2017 registration form

Page 1

2017 Winter Term Registration OLLI West Are you a member of: OLLI Central?

OLLI South?

NAME_________________________________________________ ADDRESS_______________________________ CITY_______________ ZIP_________ PHONE___________________EMAIL_______________________________________ Check if: New Address

New Email

New OLLI Member

PLEASE READ:   

Some classes require additional fees for materials. The catalog class description will note if a fee is required. The catalog specifies which classes the fee is to be paid to the facilitator rather than to OLLI. If this is a mixed site registration, and fees are due for classes at the other sites, send the class fee to the applicable site.

Class #

OLLI Location

(Only West has class numbers)

Class Name – list in order of preference

Check(s) Enclosed:

Day

Fee

West

Central

South

CHECK #

TUITION/MEMBERSHIP

$ 130

TOTAL OTHER FEES PAYABLE TO OLLI

TOTAL AMOUNT OF FEES

A separate check for fees is required.

$

Please make checks payable to OLLI West and mail to:

OLLI WEST 12081 West Alameda Pkwy, #436 Lakewood, CO 80228

Volunteers are the fuel that sustains this extraordinary learning opportunity. Get involved! Make new friends! Make a difference! Become a classroom assistant for one of the classes you have chosen to take!

YES!! I want to be a Classroom Assistant for one of my classes:


OLLI GIVES TO OLLI OLLI is able to offer high quality programs because of the support provided by member dues, earnings from the Osher Foundation endowment, and donations from members. Please consider OLLI as a worthwhile organization for your gift giving. Every contribution, no matter the size, is both tax deductible and meaningful! To make a gift, please write a separate check and note on it that it is a donation. TAX DEDICTIBLE DONATION

AMOUNT:

CHECK #

$

Please make all checks payable to OLLI West and mail to: OLLI WEST 12081 West Alameda Pkwy, #436 Lakewood, CO 80228

For information and/or questions, contact: Susan Schmetzer – 303-503-3992 susanolliwest@gmail.com

Dara Hughes – 303-912-9389 daraolliwest@gmail.com


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