MoMA.org | Education

MoMA Course Registration Form

•	For course descriptions visit http://www.moma.org/education/courses.html.
•	PAYMENT FORM: please print, complete, and fax or mail to MoMA Courses Department of Education The Museum of Modern Art 11 West 53 Street New York, NY 10019 FAX: 212-333-1118 MoMA accepts checks (made payable to The Museum of Modern Art) and credit cards (American Express, MasterCard, and Visa). If you would like to become a MoMA member, please visit http://www.moma.org/support/membership.html.
•	If you encounter any problems with the course registration form please call 212-408-8441 or e-mail courses@moma.org.

Last Name
First Name
Street Address
City
State
Zip Code
Email Address
Confirm Email Address
Phone	– –

How did you hear about MoMA Courses? Check all that apply	Membership Information MoMA website Friend Other, please specify:
Are you a member?	Yes No
If yes, what is your member number?
Have you taken a MoMA course before?	Yes No
Are you interested in receiving monthly MoMA E-News?*	Yes No
*E-News is a monthly e-mailed overview of exhibitions, screenings, lectures, symposia, and courses for adults.

Select a course. If you are enrolling for more than one course check here

If your first choice is full and you are interested in enrolling in a different course or courses, please list the alternate course name, instructor, and number:

If the course(s) you selected is full and you would like to be placed on the waiting list, please check here:

Additional comments and questions