Pauline Center for Media Studies

Registration form: Advanced Certificate in Media Literacy 2016

To register please copy and paste this form into a Word or text document, fill it out and send with your check for $225.00 to:

Pauline Center for Media Studies

Att. Registrar

3908 Sepulveda Blvd

Culver City, CA 90230

(Make check out to DAUGHTERS OF ST PAUL)

Deadline for registration: July 5, 2016

This registration for 6 1/2 day course. For information please contact Sister Nancy at pcms@paulinemedia.com.

Registration Form 2014 – 2015

Name _________________________________________________________________

Address _________________________________________________________________

City  _______________________________________ State _____  Zip _________

Current ministry or educational role/interest:

Parish, Diocese, Organization

Best phone  _______________________  

Cell phone  _________________________________

Email Address _________________________________________________________________

___ I enclose my check in the amount of  $225.00 for the 2016 Media Literacy Advanced Certificate Course.

___ I understand that I am responsible for all transportation, accommodation, health insurance and meals except for continental breakfasts, morning and afternoon breaks, and one dinner.

Signature _____________________________________________________________

For further information contact:

Sr. Nancy Usslemann, FSP

Director

PCMS@paulinemedia.com