PCCLC Registration Form (2017-2018 School Year)
After finishing the registration, please mail the form with a paycheck to

"PO Box 871503, Canton, MI 48187".
Please pay to "PCCLC"

Have Questions? Contact rongcb@gmail.com

Available Classes
Father *
If not-applicable, please fill N/A
Your answer
Mother *
If not-applicable, please fill N/A
Your answer
Legal Guardian (Optional)
Your answer
Primary Contact *
The form will lead to related section based on your choice
Street Address *
Your answer
City *
Your answer
Zipcode *
Your answer
Primary contact email *
Your answer
Primary contact phone *
Your answer
Secondary contact email
Your answer
Secondary contact phone
Your answer
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