Fayetteville Community Education Registration Form
Class enrollment is guaranteed upon receipt of payment. Payments may be mailed to:
Fayetteville Adult & Community Education
612 S. College Ave
Fayetteville AR, 72701
PLEASE DO NOT MAIL CASH PAYMENTS.
Email address *
First Name *
Your answer
Last Name *
Your answer
Middle Initial
Your answer
Mailing Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Date Of Birth *
MM
/
DD
/
YYYY
Primary Phone: *
Your answer
Alternate Phone:
Your answer
Email Address
Your answer
Gender
How did you learn about our community education program?
Your answer
Other classes that you might be interested in?
Your answer
Class Number *
Your answer
Refund Policy
** In the event that a class is cancelled, or a student withdraws before the date of the first class, a full refund will be issued. Any student who withdraws before the date of the second class will be issued a 50% refund. No refunds will be given after the date of the second class.**
A copy of your responses will be emailed to the address you provided.
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