Five Town CSD Adult & Community Education Registration Form

Have you registered for classes with us before?

o Yes   o No

Registrant Name:                                                                                                                       

Address:                                                                                                                                        

Email:                                                                                                                                              

Phone Number:                                 Date of Birth (optional):                                                                            Over 65 o Yes

Payment Method

o Check - Payable to: Five Town CSD Adult Education o Credit Card

Card Number:                                                                                                                        Exp Date:                Amount $    

Cardholder’s Name:                                                                                                                                              

Signature:                                                                  

Zip Code for CC Billing:                                                                   CVV                                  

**Please call before mailing to confirm availability**

• Refund Policy:

  Registration fees will be refunded if we cancel a course or if a student withdraws at least two weeks before the start of a      course. A 10% processing fee will be retained if a student withdraws within 14 days and up to 2 business days before the start of a course. No refunds are made after a class has started or within less than 2 business days of the start of a one-day class. 

    Materials and ingredients fees are not refundable. Exceptions to this policy may be made at the discretion of the Director. 

• Senior Citizen Discounts:

  Participants 65 or older can choose to take a 25% discount off their registration fee where noted. 

• Registration Confirmations:

  Because we serve more than 2,000 students each year and we are a small office, only students who provide an email address will receive confirmation of enrollment.

• Inclement Weather:

  We do not always cancel when day school cancels, it depends on the timing of the weather event. Notification will be posted on our website or on our telephone answering machines. We also do our best to call everyone when we need to cancel or reschedule due to weather. Virtual classes are held regardless of school cancellation due to weather.

• Changes & Cancellations:

  We reserve the right to cancel courses, change times, and substitute instructors as necessary.

207.236.7803  adult.education@fivetowns.net   

mail form to Adult Education, 25 Keelson Dr., Rockport, ME, 04856    

form revised 8.12.26