CCLTC Membership Form
The form is for new members and membership renew.


Please mail your check to:

CCLTC Workshop Registration
Houi-Lan Coker
655 Carved Terrace
Colorado Springs, CO 80919

*make check payable to CCLTC and include your Chinese name on check

Member Information
English Name *
Your answer
Chinese Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Email *
Your answer
Job Title *
Your answer
Phone Number *
Your answer
School Names *
List school names where you teach Chinese program, can be more than one
Your answer
School District *
What school district your school belongs to
Your answer
How Many Students *
List the number of students in your school's Chinese program or class
Your answer
Learning Interest Areas
To help CCLTC future training workshops
Membership New/Renewal
Membership Type *
Membership Fee *
Student Membership needs Student ID copy
After the application, you will receive a confirmation through your email.
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