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Augsburg College


The Paideia Group

Registration Form

Please print the form when completed and mail to:

Paideia Program, Augsburg College, 2211 Riverside Ave., Minneapolis, MN 55454; attention: Anne Kaufman, CB #312

_____ My check, payable to Augsburg College - Paideia Program, is enclosed.

_____ I wish to charge on my credit card.

VISA or MasterCard # (circle one): _____________________________________

Expiration Date: _______________

Signature:____________________________________________________________

Augsburg Summer Paideia Institute
Personal Information
First/Last Name:
Home Street Address:
City:
State/Province:
Zip/Postal Code:
Country:
School/Grade/Subject:
Phone:
E-mail:

(Please note that this is a printable form only)

The Paideia Group, Inc.
Copyright 2008. Augsburg College. All rights reserved.