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Mary Francis Clarke Photograph
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Registration Form

Download the 2016-2017 Brochure.

Print

Name:
Street Address:
City:
State:
Zip:
Telephone (day):
E-mail address:
Previous Participant: Yes No
Name of Class: 1.
2.
3.
4.

Upon receipt of your registration form you will automatically be placed in the classes you wish unless you are notified otherwise. Access cards are provided for entrance to the building; note the time schedule at the front of this brochure. For more information, call the Roberta Kuhn Center 563.588.2351 ext. 5345 or email: robertakuhncenter@bvmcong.org, Karen Kane-Herber, Director.

Please make checks payable to Roberta Kuhn Center or pay fee at class.

Registration fee $25 per class plus supplies listed with class description.

Check is enclosed: Amount $

Return registration to:

Roberta Kuhn Center
1150 Carmel Drive
Dubuque, Iowa 52003