TECCS Titan for a Day-Middle School-Application
Middle school students in 5th grade-8th grade are invited to spend a day with our students and staff. Students will be paired up with a member of our student government.
Student First Name *
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Student Last Name *
Your answer
Current grade: *
Current School: *
Your answer
Parent First and Last Name: *
Your answer
Cell Phone Number: *
Your answer
Work Phone Number: *
Your answer
Emergency Contact Number *
Your answer
Email *
Your answer
Please select a first choice date: (must be at least one week in advance) *
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Please select a second choice date: (must be at least one week in advance) *
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How did you hear about this program?
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