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MLS Learning Academic and Enrichment Workshops Registration Form
Student's Name *
Student's Date of Birth and Age *
Parent's Name *
Address *
Home phone number *
Parent's Cellphone number *
School / Grade *
Emergency Contact Name and Telephone Number *
What special needs does your child require or subject areas they need to work on? *
Is your child currently qualified for a free/reduced Lunch Program? *
Required
Does MLS Learning, Inc. have permission to photograph your child during activities? *
Required
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