SMU 2009 Summer Youth Workshops Registration Form

Participant Name

Grade Level in Fall 2009

Name of Parent

Address

City, State, Zip

Home phone

Work phone

T-Shirt Size (1 free T-Shirt with 1st registration)

Youth Sm. Youth Med. Youth Lg. Adult Sm. Adult Med.

Adult Lg. Adult XL

E-Mail

Workshop Title

Section

Dates

Cost

Confirmations are sent by e-mail.  To what e-mail address would you like yours sent?

Payment Amount:

Payment method:

Check (payable to "SMU Programs for Youth")
MasterCard Visa Discover

Name on Card:

Account Number:

Expiration Date

COMPLETE this form; then PRINT it and either:

FAX it to:  972-473-3449
OR
MAIL it to:  SMU Summer Programs for Youth, 5236 Tennyson Parkway, Plano, TX 75024.

Need help?  Call 214-768-5433