Junior Day Registration

*First Name:
Cowley Junior Day April 18, 2012 Main Campus - Arkansas City Please fill out the form below to register for the Cowley Junior Day or give us a call at 620.441.5594 and talk to Lory. Email west@cowley.edu. Registration begins at 9:30 am in the Brown Center lobby, 215 South 2nd Street, Arkansas City, KS WIN an Blu-Ray Player! Wear the most outrageous Dodgeball outfit and you will have a shot to win a new Blu-ray Player.
*Last Name:
*Address:
*City:
*State:
*Zip:
Phone Number:
Cell Phone:
E-mail Address:
*High School:
How many of your parents plan to attend:


*Required Field