Comhaltas Ceoltóirí Éireann Delaware Valley Branch Class Registration Form

Name(s):

Address:

Phone:

E ­ Mail:

Type of Class:

Class Location:

Class Session:

(Class Session: e.g., Spring 2010, Fall 2010, etc.)

Amount Paid:$

($70 member, $110 non-member, 2 family members $60 each.3 or more family members $50 each.If two or more classes are taken, $60 per class for members.)

Membership Information

Please check the appropriate membership type for the current year. (Note: If you are already a member of CCE-DV for the current year, please disregard. All memberships are due for renewal in the fall.)
__ $25.00 • First Senior Membership. (Includes TREOIR magazine subscription)
__ $8.00 • Other Adult members in the same family or household.
__ $4.00 • Junior members under 18 years of age.
__ $16.00 • Junior members under 18 years of age. (Includes TREOIR magazine subscription)
__ $35.00 • Family Membership (Includes TREOIR magazine subscription) If applying for Family Membership, please list both adult and children's names: