Spring/Summer 2008
REGISTRATION FORM

 
 
You must first submit this registration form before purchasing classes.
 

 

 

 

 

Student Last Name:

Student First Name:

Grade/Age (children only)

Responsible Party:
(children only)

Courses:
(List all courses you plan to pay for.)

Check box if you are a member of:

Coos Art Museum
Boys & Girls Club Member

Address:

City:

State:

Zip Code:

Primary Phone:

2nd Phone:

Email address:

Click here for information on becoming a member.

Once you click "Send", your registration will be directed to Coos Art Museum. You will need to mail a check payable to: Coos Art Museum/Art Education, 235 Anderson Avenue, Coos Bay, OR 97420.