Teen Writer! Series Application

Payment Methods
You have two choices for payment. You can pay by major credit card by filling out the form below and clicking the "Pay Now" button. This will take you to the Paypal site where you can make your payment following their simple instructions.

The second way to pay for your program is to download, print and complete the registration form (PDF) and mail back with a check made out to Luminari.

Luminari, Inc.
PO Box 81603
Pittsburgh, PA 15217

Application Form

Full Name*
Street Address*
	City* State* Zip*
Daytime Phone*
Evening Phone*
Email Address*
If applicant is under 18 years old
	Date of birth Guardian's name School you attend Current grade
Program(s):	BLOGS, REVIEWS, ESSAYS, AND COMMENTARIES --- FOR TEEN WRITERS WITH ATTITUDE Tuition: $159.00 FANTASTIC FICTION WRITING: 3-DAY SUMMER CAMP FOR TEENS Tuition: $439.00 ($479.00 after May 1, 2012)
Please check here if this is a gift (a printable gift certificate will be e-mailed to you.)
	Email Gift Certificate to:
How did you learn about this program?
Coupon Code:

Please note: Tuition is not refundable.

Have any questions about these programs?
For more information regarding these and any other Luminari program or project please call 412-877-1888 or email luminari@luminari.org