Connecticut Natural Science Illustrators

In Collaboration with Yale Peabody Museum

Registration Form

Please print this form and complete. When printing this form, use the "Print Preview" option to adjust the document size, if necessary.

Name:_______________________________________________________________________

Street Address:________________________________________________________________

City:_____________________________________State:_____________Zip:_______________

Home Phone:______________________________CellPhone:___________________________

Email:___________________________________I am a new _____ or a returning _____ student.

Required for #200 level courses and above: I have completed the prerequisite____or I have instructor's permission to enroll_____

I have read CTNSI's policies and procedures. _______

Course Title/Instructor_____________Date(s)_________Day______Time______CourseFee

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Total Fee Due: _____________

Form of Payment: Personal check made out to Connecticut Natural Science Illustrators.

Payment will not be processed until the class begins. Full payment will be refunded in case of cancellation.

Please mail the upper part of this form to:

CTNSI Program Coordinator
PO Box 4133, Madison CT 06443-4133

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Location of classes and parking information: Classes are held in the Yale Peabody Museum Community Education Center on Yale University’s West Campus, 117 Frontage Rd., Orange CT 06477. Directions and parking information: www.ctnsi.com and www.peabody.yale.edu/education or phone: 203.530.3276. The classroom building is handicapped accessible.
CTNSI Policies and Procedures.

Registration: Registrations are processed upon receipt. A letter of confirmation and materials list will be mailed within ten business days of receipt of registration form and course fee. If a course is full, students will be notified by mail and the tuition check returned. Registration information: email: ctnsiregistrar@comcast.net. or phone 203.421.1961. All other queries: clgilbane@gmail.com or 203.934.0878. Students will be charged $25 to cover the cost of a check returned for insufficient funds.
Enrollment eligibility: Classes are designed for adults. Students under 18 years of age will be admitted with permission from the instructor.

Class size: Enrollment in each class is limited. Register early to assure a place. If a class is full, interested students may sign up on a waiting list with no fee required to hold a place. Students will be notified in the event of an opening and may register at that time.
Materials list: A materials list will be sent with confirmation. Students should allow time to purchase materials before the first day of class.

Course cancellation: If a course is cancelled, students will be refunded 100% of the fee.
Refund policy: If a student withdraws from a course prior to the first day of class, the following schedule will apply:
2 weeks or more before course begins: Course fee less $15 processing fee.
Less than 2 weeks but 24 hours before course begins: 50% of course fee.
Day course begins: no refund without a legitimate medical excuse signed by a physician.
All withdrawals must be made in writing in a letter to the registrar. (This can follow an email message or a phone call to the registrar.)
Course prerequisites: Some courses require prerequisites or special permission of the instructor. These requirements are included in the course description.

Class cancellations: Inclement weather: It will be the student’s responsibility to check if a class will run. Phone: 203.421.1961, 203.415.6601 or 203.530.3276.
If an instructor cancels a class, he/she will make every effort to notify the students by email and/or phone in a timely manner.
Curriculum changes: CTNSI reserves the right to change its calendar, withdraw or modify a course and/or substitute instructors. CTNSI will make every effort to notify students of such changes.


Connecticut Natural Science Illustrators, PO Box 4133 Madison CT 06443-4133 203.934.0878 www.ctnsi.com