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KIPP Ma Adult and Community Learning Registration -KIPP Ma Forma de Registro Clases Comunitarias
Date- Fecha *
MM
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DD
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YYYY
First Name- Nombre *
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Last Name- Appellido *
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Home Address- Direccion de casa *
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City and State - Ciudad y Estado *
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Email Address- Direccion de correo electronico *
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Home Phone Number- Numero Telefono de la casa *
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Cell Phone Number- Numero Telefono de celular *
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How did you hear about us? Como escucho de nosotros? *
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Please select the classes that you would like to take. Por favor selecciona la(s) clase(s) que le qustaria tomar. *
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Comments/ Comentarios
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