SEMAA

Warren County SEMAA

Print this form and fill it out, then mail or fax it to the address below.

Please check only 1 session during the school year. Classes meet from 9:00 A.M. until Noon on 8 consecutive Saturdays except for holiday week-ends.

___Fall (October 2- November 22, 2010) ___Winter (January 15- March 5, 2011) ___Spring (March 19 - May 14, 2011)

You may also select one week of Summer Science Camp

Select one session. Classes meet Monday thru Friday from 8:00 A.M. to 1:00 P.M.
____Camp 1 (June 21 thru 25) ____Camp 2 (June 28 thru July 2) ____Camp 3 (July 12 thru July 16)

____Camp 4 (July 19 thru July 23)

Student/ Parent Information

Name______________________School_____________________Date__________

Address_____________________________City/State_____________________Zip_____

Grade or K ___ Date of birth________Phone (___)________________

Parent's/ Guardian Name_____________________________________Home Phone______

Address (if different from above)_____________________________________Work Phone_____________

Please complete the above information and return it to Warren County SEMAA, 149 Campus Drive Warrenton, NC 27589 or call 252-257-7015 from 9:00- 4:30 M-F to register your child. All of the first three weeks are open in all grades. Our FAX number is 252-257-7017.