Creativity in Action for Adolescents

Summer 2013 Course Registration Form

Step 1. Request your course(s) below (this registration does NOT guarantee your spot in the course).
Step 2. We will contact you within one business day with course availability.
Step 3. Once confirmed, print and mail form with a $30 cash/check deposit per class (applied to tuition).

* Questions?

First Name

Last Name

Birthdate (mm/dd/yyyy)

Gender

Address

City

Zip

School

Grade

Parent's (regularly checked) Email

Parent's First Name

Parent's Last Name

Parent's Phone

Course #1

Course #2

Course #3

Course #4

Course #5

Course #6

Scholarship Request: Coyote provides scholarships in the form of reduced tuition and/or trades & barters for our auction.

I would like to discuss scholarship options and/or make payment arrangements!

Additional questions: (206) 323-7276 or .

Coyote Central welcomes participants of any race, color, religion, sexual orientation, and national or ethnic origin.