SeniorNet Registration Form

To register for a SeniorNet course and/or workshop:

1.    Complete form below or if you have Microsoft Word software click in the following link to access a printable version of the form. Printable Version

2.    Mail with course fee to:

      Daytona Beach Computer Learning Center
524 S. Beach St.   Suite A
Daytona Beach, FL  32114

3.    Form may be sent electronically by fax or email to tentatively reserve a seat in the course(s) of your choice.  The registration is NOT complete until the course fee is received by mail or in person.  Cut-off for payment of course fee is seven (7) days prior to course start date.

Email: DBCLC@daytonabeachseniornet.org

 

Note: SeniorNet accepts only cash or checks, no credit cards. 

Please make check payable to DBCLC (Daytona Beach Computer Learning Center).

Students who find that they will be unable to attend the course may request refund for the course fee if the request is received at least seven (7) days prior to the first day of class. 

A confirmation notice will be mailed to you.

Note:   A registration form and course fees are required to reserve a place in the course.  Registrations are taken in order of date received.
        To make multiple selections within a box hold the "Ctrl" Key down.

 

Registration Form

Today’s Date:

Last Name            First Name          

Name you go by

Address    City & State          Zip

Phone (  )   -   E-Mail Address

Computer Experience

Access to Computer      Yes            No            

Do you have a PC (IBM, Compaq, HP, Dell, Gateway, etc) Apple/Mac

What operating system do you have?   

What application software is installed?

Please register me for the following COURSE(s):

Introduction to Vista: $50.00------------------------------------------------------------  Fee

           

                        See below for GS2 Vista

Getting Started 1: $10 -------------------------------------------------------------------- Fee

           

Getting Started 2: $50.00 ---------------------------------------------------------------  Fee

           

Getting Started 2 Vista: $50.00 ---------------------------------------------------------  Fee

           

Getting Started 3: $50.00---------------------------------------------------------------- Fee

           

Internet & E-mail: $50.00 ---------------------------------------------------------------  Fee

           

Digital Photo Processing $40.00 --------------------------------------------------------- Fee

           

Spreadsheet:  $30.00 ---------------------------------------------------------------------Fee

       


PC Security &  Housekeeping (Old)  $10.00 ---------------------------------------------Fee

            

PC Security &  Housekeeping (New)  $30.00 --------------------------------------------Fee

            

Genealogy [Family Tree Maker]: $50.00 -------------------------------------------------Fee

           

Personal Finance [Quicken]: $50.00 -----------------------------------------------------  Fee

           

Please register me for the following WORKSHOP(s):

$10.00 each workshop -----------------------------------------------------------------  Fee

           

Calculate Fees

Total Course Fees ------------------------------------------------------------------------

Total Workshop Fees --------------------------------------------------------------------  

 

            TOTAL REGISTRATION FEE(S)-----------------------------------------------

  Submitted form will reserve a TEMPORARY space in the selected course/workshop.

            A copy of this form along with total fees must be received 7 days before class is scheduled to begin.
            Print* this form and Mail to:

            Daytona Beach Computer Learning Center
            524 S. Beach St     Suite A
            Daytona Beach, FL  32114

            * To print the form click on File/Print. Set your printer paper orientation to Landscape.