Issue link: http://townofcary.uberflip.com/i/420645
62 January–May 2015 Cary Senior Center Registration Form Participant's Last Name ________________________________ First Name ______________________________________ Class Class/ Workshop Day Date(s) Time Fee* Code Title _______________ _____________________________ __________ _______ ________ _____________ _______________ _____________________________ __________ _______ ________ _____________ _______________ _____________________________ __________ _______ ________ _____________ _______________ _____________________________ __________ _______ ________ _____________ _______________ _____________________________ __________ _______ ________ _____________ _______________ _____________________________ __________ _______ ________ _____________ _______________ _____________________________ __________ _______ ________ _____________ _______________ _____________________________ __________ _______ ________ _____________ Transfer this total to the other side: $ __________ Cary Senior Center Memorial Garden Plaza Remember a loved one with a gift to the Cary Senior Center Memorial Garden Plaza. With your $ 50 or more donation, an engraved brick will be placed in the Memorial Garden Plaza, surrounded by beautiful gardens and a relaxing fountain. This tax-deductible contribution will show your dedication to the Cary Senior Center, while honoring or memorializing a loved one, friend or yourself! Fill out this form today and return it with a separate check for $ 50 or more made out to: Friends of the Cary Senior Center, Inc. Call (919) 469-4081 for more information. Please print text in the spaces provided below. There is a maximum of 3 lines and no more then 17 characters per line (characters include let - ters, dots, dashes, spaces, numbers, etc.). Please use a separate form per brick. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ If this is a gift, please acknowledge to: Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ City/State: _ _ _ _ _ _ _ _ _ _ _ _ Zip: _ _ _ _ _ _ _ _