Register for New Member Discovery Classes
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• The next series of New Member Discovery Classes will be held January 8 - February 12, 2012
• Sunday classes meet 9:15-10:15 am in the Lounge
• Wednesday classes meet 6-7 pm in the Lounge and repeat material presented on Sunday
• Those who choose to join Derry Church will be received on Sunday, February 12, 2011
• Please register by Wednesday, January 4, 2011

First Name:
 Middle/Maiden Name:
 Last Name:
Street Address:
City:
 State:
 Zip:
Home or Main Phone:
 Work Phone:
 Cell or Other Phone:
Email:

A note on child care:
Child care is provided on Sunday mornings, and will be provided on request for the Wednesday evening classes. Please indicate which evenings you will need child care, and type in the name(s) and age(s) of your child(ren) in the comments box below.

Please check the classes you plan to attend:

11

 Child care needed on 1/11?    


Child care needed on 1/18?  
Child care needed on 1/25?  
Child care needed on 2/1?  
Child care needed on 2/8?    
 
 
 

Comments:
• Please include your reason for taking the class, such as "membership" or "informational purposes"
• If you know there is a week you cannot attend, please list it here
• Please include name(s) and age(s) of children who will need care on Wednesday evenings

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