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Burlington Sons of Italy Lodge 2223
Italian Classes

REGISTRATION FORM
ITALIAN LANGUAGE CLASSES-2010-2011 SESSIONS
Location: St. Margarets School, Winn St., Burlington, MA (Beginner & Intermediate) and 27 Evans St. Stoneham, MA (intermediate Advanced Only)
Class Fee: $80.00 for 10 Weeks (non-refundable fee)

Registration Night: Wednesday, September 15, 2010 from 6-7 pm St. Margaret's School Building, 109 Winn St., Burlington, MA

Name:________________________
Address:
Phone (Home):
Phone (Cell):
Phone (Work):_
Email____________________________
PLEASE CHECK ONE:
Beginner 1 _
Beginner 2 _
Intermediate 1 _
Intermediate 2 _
Intermediate Advanced _
Indicate your knowledge of Italian:_______________
Reason for taking this class:_
PLEASE MAKE CHECK PAYABLE TO: Burlington Sons of Italy Lodge 2223 for $80.00
Mail your registration early – registration cut-off date is: September 20th.

Registration Policy-Registration fee is non-refundable.
I agree to this policy (Signature Required)
PRINT AND MAIL REGISTRATION FORM AND CHECK TO:
Phil DAlleva
15 Edgemere Ave
Burlington, MA 01803
If you have any questions, please call Phil DAlleva, (program director) at 781-272-4305 or email at dalleva@comcast.net.

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