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Please complete the registration form below.
Organization:

Coquitlam Montessori Society

Event:

2022/23 Donation and Membership

Date/Time: Fri, 02-Sep-2022 - Fri, 30-Jun-2023
Person 1:
First Name:    (*)
Last Name:    (*)
Address:     (*)
Apartment: 
City:     (*)
Postal Code:     (*)
Prov./State: 
Country:     (*)
Home Phone:     (*)
Business Phone: 
Mobile Phone: 
Email:     (*)
  I have read and agree with the Terms of Use   (*)
 
 
 
Name on Tax Receipt /First Name:
Last Name:   (*)
 
Student First Name:   (*)
Student Last Name:   (*)
Student School:    (*)
Teacher Name:   (*)
 
Student 2 First Name:
Student 2 Last Name:
Student School 2:
Teacher 2 Name:
 
Student 3 First Name:
Student 3 Last Name:
Student School 3:
Teacher 3 Name:
 
Student 4 First Name:
Student 4 Last Name:
Student 4 School:
Teacher 4 Name:
 
Donation Amount:  Format: 100.00 (no $ sign); suggested amount: 100.00 per family   (*)
Volunteer: Yes   No   (*)
 
Would you like to be a member?
 
 
Refund Policy:
No refunds will be provided.
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