November 28, 2017 Afternoon Session
Student's First Name *
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Student's Last Name *
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Gender
Current Grade *
What school do you currently attend? *
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Are you interested in an athletic program? *
Are you interested in a fine/performing arts program? *
Are you interested in a world language? *
Are you interested in any other program? *
Parent/Guardian's Name *
Your answer
Parent/Guardian's Work Phone Number *
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Parent/Guardian's Cell Phone Number *
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Email address to use for confirmation of visit? *
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Any allergies or medications? *
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Emergency Contact Name *
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Emergency Contact Phone Number *
Your answer
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