ATM Registration Form

Please print clearly

Name ____________________________________________________

Address __________________________________________________

City ________________________ State ______  ZIP _____________

Phone _________________Email _____________________________

I wish to enroll in the following ATM class

 Wednesday evenings (6 to 7 pm)

 Friday mornings (9:30 to 10:30 am)

$40 per series

Make check payable to Judith Dila and mail with registration form to:

Judith Dila

310 N. Ferry Street

Ludington, MI 49431