Please fill out completely.


Student's Name *
Student's Name
Gender *
Session(s): *
Name of Parent or Guardian *
Name of Parent or Guardian
Primary Phone
Primary Phone
Alternate Phone *
Alternate Phone
Home Address *
Home Address
Emergency Contact Name *
Emergency Contact Name
Name as it appears on card
Name as it appears on card
Expiration Date
Expiration Date

Please post checks or money orders, made payable to California Film Institute, to:
SummerFilm 2017
CFI Education
1001 Lootens Place, Suite 220
San Rafael, CA   94901

Your credit card will be charged on May 15.

Cancellation Policy:
After May 15 – before June 15: 50% Refund
After June 15: No Refund

If you need assistance, or would like more information:
Please call 415.383.5256, ext. 113, or email: education@cafilm.org