High School: Late Class Sign-Up (Session 5 Only)
We're so happy you're interested in CIP Session 5! This sign-up form is for the high school student to complete with their parent/guardian. Both the student participating in Connect-in-Place and their parent/guardian must be present to fill out this form, as it includes a waiver that the parent/guardian must sign.

This form was due by Friday, February 19 at 12:00 noon PDT. Late sign-ups are still being accepted, but there's no guarantee that you'll be placed in a class.

Class Titles and Descriptions are attached here:
https://tinyurl.com/S5HSClasses

IMPORTANT: The more classes you rank, the more likely you are to be placed in a class! Connect-in-Place reserves the right to not place students in any class.
Email address *
Parent Name *
Parent Email *
Parent Phone Number *
Student Full Name *
Student Email (where we should send the Zoom link to) *
Student Phone Number *
Please like/follow our social media accounts for important info on classes and program-wide events!
Facebook: https://www.facebook.com/connectinplace
Instagram: @connect.in.place https://www.instagram.com/connect.in.place/
LinkedIn: https://www.linkedin.com/company/connectinplace/
Have you liked/followed our social media account for important info on classes and program-wide events? *
Which CIP sessions have you attended in the past? *
Required
How did you hear about us? *
Student's Gender *
Country of Residence *
State *
City of Residence? *
Student Age *
Student Grade *
For the student: How likely are you to attend all your scheduled classes? *
Are you willing to take any class? *
Student & Parents: I have read the full class schedule and understand that some classes have special requirements and prerequisites. I understand that if I do not meet these prerequisites, I will be dropped from the class during the first week. *
Required
First Choice Class *
Second Choice Class
Third Choice Class
Fourth Choice Class
Fifth Choice Class
For students: are you comfortable turning your video and audio on? (Required for some classes) *
How many classes would you like to enroll in? (Whether or not you will be placed in multiple classes will depend on how many students enroll in Connect-In-Place, as well as the popularity of the classes you are interested in.) *
For the parent/guardian: I have read the attached liability waiver, and agree to the Connect-In-Place terms and conditions. *
Required
For the parent/guardian: Please write out your name as a signature that you have read and agree to the Connect-In-Place terms and conditions. *
(Optional) For the student: What are you most looking forward to about Connect-In-Place?
Any questions or comments?
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