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Enrollment

 

Fields marked (*) are required

 

First Name*   - Same as on Birth Certificate
Middle Name*   - Same as on Birth Certificate
Last Name*   - Same as on Birth Certificate
Birth Date*   - MM / DD / YYYY
Grade in School*
Address*
City*
Zip Code*
Tel Nbr*
(no hyphen)
Email Address*
Location*
Class Start Date*
(from Schedule)
Time*
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