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Online Registration (due March 1)
What grade level will you be WHEN you take this course? *
First Name: *
Your answer
Last Name: *
Your answer
Gender: *
Date of Birth: *
MM
/
DD
/
YYYY
Student Email: *
Your answer
Race: *
Are you Hispanic? *
Do you have an IEP or 504 Plan? *
If you do not know what this is, odds are you do not have an IEP or 504 plan.
Do you participate in the Free/Reduced Lunch Program? *
Semester you are requesting course(s) for: *
Requested Course Name(s): *
Your answer
If this is a college course, which college is it from?
Your answer
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