CoTA Literary Institute 2022

CoTA VIRTUAL LITERARY INSTITUTE

Monthly Sessions Starting September 2022
Name *

First Name Last Name
Title/Grade *
School/District/Company *
Phone Number

Area Code Phone Number
Email *
example@example.com
What CoTA Programs have you previously participated in? *
If you were referred by someone to participate in the Fall 2022 Literary Institute, please indicate who referred you below:
Materials for the workshop will be shipped directly to your home or school. Please provide your mailing address below. *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How did you learn about the CoTA Virtual Literary Series? *

Newsletter Personal email Social Media Website
Refundable Registration Deposit $90:
Deposit is used to hold your spot and is fully refunded upon completion of institute. All sessions must be attended.

Refund:
Registration fee refunded upon completion of Institute. If payment made by PayPal, refund will be $85 to include a $5 processing fee.
PayPal:

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Media Release: Please review the media release below and sign if you are comfortable providing CoTA with agency to use your photo, project, and particiaption on our website, blog, social media platforms, and in videos.

I give CoTA (Collaborations: Teachers and Artists) permission to take and use photographs or recordings of my participation taken during the Literary Workshop Series and use and sublicense, such material for any purpose in print, advertisements, videos, online, and broadcast presentations of any sort.
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CoTA VIRTUAL LITERARY INSTITUTE