JERSEY SHORE AREA SCHOOL DISTRICT
175 A & P Drive
Jersey Shore, PA  17740
Phone:  570.398.1561
Fax:  570.398.5089

 

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Community and Continuing Education
Registration Form--Spring 2010

 
 

 

   If you have any questions regarding registration please contact:
John E. Wilt, Director
Community and Continuing Education
570.398.7170 Ext. 1015
570.279.1075 (cell)
jwilt@jsasd.k12.pa.us
 
Name   *
Mailing Address   *
City  *
State  *
Zip Code  *
Phone Number (including area code)    -                           -                         *
Email  *
         
Resident of Jersey Shore Area School District
*
Non Resident of Jersey Shore Area School District *
Senior Citizen (62 or older) *
ACT 48 Credit *
     
Course1  
All courses are listed in alphabetical order.
 
Course2  
All courses are listed in alphabetical order.
  
Course3  
All courses are listed in alphabetical order.
   
Course4  
All courses are listed in alphabetical order.
Credit/Debit Card Number
(Visa or Mastercard Only)   -     -    - 
Expiration Date
(Mo/Year)   

 

Security Code (from back of credit card)
(code) 

 


Comments/Notations


Make check/money order payable to:   JSASD 

Mail check/money orders to:
Jersey Shore Area Senior High School
Attention John Wilt
701 Cemetery Street
Jersey Shore, PA  17740

If you have any questions regarding registration, please contact:
John E. Wilt, Director
Community and Continuing Education
570.398.7170 Ext. 1015
570.279.1075 (cell)
jwilt@jsasd.k12.pa.us

* Required Fields

 
 
 		  
 

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