Student's Name__________________________________________________________
Parents' Name _________________________________________________________
Student's Date of Birth ____________________________________________________
Street Address __________________________________________________________
City, State, Zip code ______________________________________________________
Phone Number __________________________________________________________
E-mail Address (both parent and student, if applicable)_____________________________
How did you hear about this course?___________________________________________

Check the course for which you are registering. All times are pacific time.

_____ Introduction to Latin -- Tuesday and Friday, 8:00-8:50 a.m.
_____ Latin 1: Section A -- Monday, 8:00-9:50 a.m.
_____ Latin 1: Section B -- Tuesday, 10:00-11:50 p.m.
_____ Latin 2 -- Monday, 10:00-11:50 a.m.
_____ Latin 3 -- Wednesday, 10:00-11:50 a.m.
_____ Latin 4 -- Wednesday, 8:00-9:50 a.m.

_____ Logic -- Tuesday, 9:00-9:50 a.m.
_____ Introduction to Great Books -- Thursday, 8:00-9:50 a.m.
_____ Great Books 2 -- Thursday, 1:00-2:50 p.m.
_____ Great Books 4 -- Thursday, 10:00-11:50 a.m.

TOTAL AMOUNT ENCLOSED__________________________________ (see fees description on registration page )

Fees do not include books or software. All payments and deposits are non-refundable due to server lease commitments. Make checks payable to Artesian Wells. Mail this form with payment to:

Artesian Wells
213 S. Monroe St.
Moscow, ID 83843