"C" for Yourself!

Name and Contact Information

Student First Name

Student Last Name

Student Nickname

Student Mobile Phone

Street Address

City

State or Province

Zip Code

Country

Optional Information

Parent/Guest Names

Parent Phone Number(s)

Parent Email Address

Student T-shirt Size

Special needs/Anything else you would like us to know

For students/guests traveling over 100 miles, complimentary local lodging for one night may be available.
*If available, would you like us to reserve a room for you at a local hotel?

YesNo

Please indicate the day on which you would like us to make your lodging reservation.

November 7th, 2024November 8th, 2024

Would you like to attend the Sweeny Todd play at Cottey's Center for the Arts on November 8th at 7:30 p.m.?

YesNo

Program Information

Anticipated Start Term

Anticipated Start Year

Student Type

Contact Information
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