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 *

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

Day of the Week: First Choice *

Day of the Week: Second Choice *

Would you like to add an EVERY OTHER WEDNESDAY option? *

Please add up your total amount due *

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

How would you like to make the first quarter's Computer Club payment *

You have two options for payments *

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