Collegium Hall Registration Form 2016-2017
"Learning Lab"
Student Last Name:
Your answer
Student First Name:
Your answer
Campus Location
Student Grade
Days Student Will Attend:
Please Select all the days you want your student to attend.
Required
Emergency Contact Name
Your answer
Emergency Contact Phone #
Your answer
Emergency Phone Number to Text #
Your answer
Email Address
Your answer
Student ID # (4 Digit Number off Aspire)
Your answer
E-Signature
By typing your name in this box, you agree that all the above information is correct.
Your answer
Date:
MM
/
DD
/
YYYY
Who is authorized to pick them up?
It can be a parent, older brother/sister, grandparents or Aunts & Uncles
Your answer
Submit
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