Course Registration Form
Center for Creative Learning, Milwaukee, WI
Fill out and submit this form to register for any course listed in "Course/Date" below.
For specific date details, see the calendar or click on More Info on a specific item below.

Course/Date*

Please select all
courses/events you wish
to attend; if you are
considering multiple
dates for a course, select
each consideration.

Show only: (warning: this clears the form)

  Course/Event Specifics Start Date  
Taking It LightlyOctober 2010October 1, 2010More Info opens in a new window
Taking It LightlyNovember 2010November 5, 2010More Info opens in a new window
Taking It LightlyDecember 2010December 3, 2010More Info opens in a new window
Taking It LightlyJanuary 2011January 7, 2011More Info opens in a new window
Taking It LightlyFebruary 2011February 4, 2011More Info opens in a new window
Taking It LightlyApril 2011April 1, 2011More Info opens in a new window
Taking It LightlyMay 2011April 29, 2011More Info opens in a new window
Taking It LightlyJune 2011June 3, 2011More Info opens in a new window
Taking It LightlyJuly 2011July 8, 2011More Info opens in a new window
Taking It LightlyAugust 2011August 5, 2011More Info opens in a new window
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Gender*
First Name*
Last Name*
Email
Occupation
Birth Date  (format m/d/yyyy)
Street Address
City
State
Zip
Home Phone**  (format 123-456-7890)
Cell Phone**  (format 123-456-7890)
Work Phone**  (format 123-456-7890)
Comments

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**At least one telephone number is required

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