CADET REGISTRATION FORM


Cadet and Midshipmen Academy Registration Form
Continental Sloop Providence -

Name:____________________________________________

Date of Birth: __________________

Grade:__________School:_______________________________

Week Choices:________________________________________

Name of Guardian or Parent:____________________________

Relationship:__________________________________________

Address: _____________________________________________

City:________________State:______ Zip: __________

Home Phone:______________________________________

Work Phone:______________________________________

Email:____________________________________________

Please return this form and a 50% deposit to register
Tuition is $ 850 (per week) for Cadets,
$900.00 (per week) for Midshipmen

Total amount enclosed:___________

Upon receipt we will send you a complete Cadet packet, information sheet, and emergency medical form.

The PMHF accepts checks, Visa, MasterCard and
American Express.

 

Card #:_______________________________________________

Exp. Date:_______-_______-_______

Name: _______________________________________________

Signature:____________________________________________

 

 

Print out this form, complete it and mail to:
Adria Lande, Education Director
Providence Maritime Heritage Foundation
408 Broadway, Providence, RI 02909

or fax form to PMHF (401) 828-8788

For more information , please email Adria at
adria_sloopprovidenceri@cox.net
or
call her direct line at 401-274-1776

 

 

 
 
© 2018 Providence Maritime Heritage PNTDN.