b'Registration FormforLearning In Retirement S P R I N G 2 0 2 0REGISTRATIONS WILL NOT BE PROCESSED WITHOUT PAYMENT; a place in your class(es) will NOT be held for you until payment is received.Register by mail: Register by phone with credit card: Register in person: ONLINE REGISTRATION Learning in Retirement 229.245.6484 Regional Center forFOR LIR NOW AVAILABLE!1500 N Patterson St TO PROTECT YOUR PERSONALContinuing Educationwww.valdosta.edu/pace/Valdosta State University INFORMATION, PLEASE DO NOTRoom 124Valdosta, GA 31698-0998 EMAIL CREDIT CARD PAYMENTS! 903 North Patterson StreetREGISTRATION CONFIRMATIONS/RECEIPTS WILL BEEMAILED along with a link to any associated maps and materialslists, if we have an email address on file for you. You may pick up your parking permit in our office at your convenience prior to your first class. If you would like your receipt sent by U.S. mail, please check the box below.qPlease MAIL my registration confirmation/receipt, parking permit, and any associated maps and materials lists.Preferred Name Legal Name (If Different) Mailing AddressCityStateZipPrimary PhoneAlternate PhoneEmailq Check here if you do NOT wish to be added to our email newsletter list.Is this your first time ever participating in Learning in Retirement?q YESq NOIf you are new to LIR, how did you hear about us? _________________________________________________________________________Fees: Check All That Apply(Other class fees may be collected by instructor as noted in class description)q$75 Spring Membership(20FLIR999) qCurrent yearly membership (paid in Fall) q$12 Spring Kick-Off Lunchq $12 Wrap-Up Lunchq$35 Bridge q $15 Animal Portraits q Subtract $15 if Volunteer Teacher for Spring 2020 TermTotal Fees: $Payment Type:qCASHRECEIPT # qCHECK #Make Payable to VSU-LIRqCREDIT CARD(MasterCard / VISA / Discover)Card HolderBilling AddressPrint Name - Exactly as it appears on card Same As Above? If Not, Print Address HereCard #Exp. Date Sec. Code(3 Digits on Reverse)VALDOSTA STATE UNIVERSITY PROFESSIONAL AND COMMUNITY EDUCATION 25'