Fax or mail registration

Kennewick Community Education Printable Registration Form

Use this form for Mailed or Faxed Registrations

1000 W. Fourth Avenue, Kennewick, WA 99336 (509) 222-5080 FAX (509) 222-5137

Click here for Secure Online Registration Form

Name	Age (if under 18)	DAT ____
		PYT _____
Address	Work Phone	RCT _____
	Home Phone	REG _____
City, State, & Zip Code		ENT _____
E-mail address		(Office Use)

Class #	Class Name	Class Fee




	*Total

Payment Method
Check One

      Acct. # ______________________________________ Expires _____________________

      Signature __________________________________________________________________
                                (For Credit Card Purchases)