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SEEDlings Application
Thank you for your interest in our SEEDlings after-school program for the 2018-2019 school year! Please fill out the information below and we will be in touch soon.
Email address *
Student's Name *
Your answer
Student's School *
Your answer
Student's Grade Level *
Student's Date of Birth *
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DD
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YYYY
Student's Race *
Parent/Guardian Name *
Your answer
Parent/Guardian Street Address *
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Parent/Guardian Email *
Your answer
Parent/Guardian Phone Number *
Your answer
Annual Household Income *
Your answer
Number of members in your household *
Why is it important for you, your family and your child to be enrolled in SEEDlings? *
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