The EduCulture Project at

FARM HANDS REGISTRATION FORM

Please PRINT, complete, and return this form with check or payment information to:
Global Source Education, PO Box 11316, Bainbridge Island, WA 98110

You can register by phone during office hours at 206-780-5797

Return to Farm Hands

 

Farm Hands Program Tuition Full Day for Juniors & Seniors, $265/week Half Day option for Juniors & Seniors, $135/week	Summer Farm Hands Sessions June 28th-July 2nd (senior, grades 3-6), 9:30-3:00 or 9:30-12:15 June 28th-July 2nd (junior, grades K-2), 9:30-3:00 or 9:30-12:15 (please circle one) July 5th-9th (senior, grades 3-6), 9:30-3:00 or 9:30-12:15 July 5th-9th (junior, grades K-2), 9:30-3:00 or 9:30-12:15 (please circle one) July 12th-16th (senior, grades 3-6), 9:30-3:00 or 9:30-12:15 July 12th-16th (junior, grades K-2), 9:30-3:00 or 9:30-12:15 (please circle one)
$35 $_______	Global Source Membership/Contribution Other Tax Deductable Contribution to support Farm Hands and the EduCulture Project.
$_______	Total Amount Due
Name of Child Parent/Guardian
Mailing Address
Day Phone
E-Mail
School & Grade Level (2010-2011)

Notes

Please make checks payable to: Global Source Education
Credit Cards (Visa or MasterCard) accepted
Credit Card Information    MasterCard     Visa    Exp Date ____/____
Credit Card Number    __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __

Parent/Guardian Signature  (required) ____________________________________
Date ________________