RAP Program for Lifelong Learners Membership/Registration Form

Please note: You must be a current member of RAP to register for activities/classes that RAP is offering. The membership fee may be included with your registration.

To register by mail - print this form. Complete form and mail with payment to Registration Office, McHenry County College, 8900 U.S. Hwy 14, Crystal Lake, IL 60012

Birth Date: _________________
Name: ______________________________________ Phone: _____________________
Address: ________________________________________________________________  
City: _______________________________ State: _________ Zip: _________________
RAP Activity/Class Title Class ID # Cost
$25 Annual Membership Fee NRA C01 001  
  Total $_____
Please make checks payable to McHenry County College or use a credit card.
Visa/MasterCard/Discover Acct. # _______________________________________
Three digit security code ____________________
Expiration date _______________________________________
Signature of card holder _______________________________________

For more information, please call (815) 455-8752.