Computer Club Registration

Please fill out the following
Mill Pond
COMPUTER CLUB REGISTRATION FORM

* Indicates required field

Parent/Guardian Name *

First

Last

Email *

Parent Cell Phone Number *

Student Name *

First

Last

If we need to contact the student for any reason, the Computer Club will ALWAYS go through the parent/guardian.
Milil Pond Computer Club will never contact a student directly.

Student Grade *

Please tell us how many and which days you'd like to attend the COMPUTER CLUB this month. REMEMBER to SAVE $25 per week by signing up for 5 days just $250 instead of $275 *

Does the student have any allergies or difficulties we should know about? *

Currently, we cannot accept credit cards.
But we do accept VENMO or ZELLE payments
(use petermeerwarth@me.com or 609-903-6560)
You will see the Mill Pond logo in VENMO.

We also accept checks made out to:
Mill Pond Computer Club

Please mail checks to:
Peter Meerwarth
Mill Pond Computer Club
20 South Main Street
Allentown, NJ 08501

Submit

Please fill out the following
Mill Pond
COMPUTER CLUB REGISTRATION FORM

We Would Love to Hear from You Soon!

Hours-6 Days

Cell Phone

Email

Please fill out the following​Mill PondCOMPUTER CLUB REGISTRATION FORM

We Would Love to Hear from You Soon!

Hours-6 Days

Cell Phone

Email

Please fill out the following
Mill Pond
COMPUTER CLUB REGISTRATION FORM