DREAM PUSHER ACADEMY (*TEENS ONLY AGES 13-18) 
DREAM PUSHER ACADEMY will be hosting FREE TEEN WORKSHOPS/EVENTS. Please complete the questions below. Upon completion you will receive a letter of acceptance and confirmation. We are looking forward to working with your teen this year!  PLEASE NOTE: SOME EVENTS ARE OPEN TO YOUNG ADULTS UP TO 21
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FIRST NAME OF YOUNG SCHOLAR *
LAST NAME OF YOUNG SCHOLAR  *
YOUNG SCHOLAR GRADE LEVEL  *
NAME OF SCHOOL ATTENDING (include City & State) *
EMAIL ADDRESS OF YOUNG SCHOLAR  *
PHONE NUMBER OF YOUNG SCHOLAR OR PARENT/GUARDIAN *
FULL NAME OF PARENT/GUARDIAN
EMAIL ADDRESS OF PARENT/GUARDIAN
EVENT/SESSION LOCATION OPTION:  *
INTERESTED IN: (*select at lease one)   *
Required
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