Power Up Summer Program Enrollment
Inscipción de Programa de Verano Power Up
Last Name/Apellido *
Your answer
First Name/Primer nombre *
Your answer
Student ID/No. de identificación del estudiante *
Your answer
Current School/Escuela actual *
Your answer
Current Grade/Nivel de grado escolar de 2018-2019: *
IEP/Plan de Educación Individualizada
ESOL/Programa de ingles para hablantes de otros idiomas *
Address/Dirección *
Your answer
City/Ciudad *
Your answer
Zip Code/Código postal
Your answer
How will your child get TO Jackson High School? *
How will your child get home from Jackson High School? *
Parent Name/Nombre del padre/madre *
Your answer
Primary Phone/Teléfono *
Your answer
Cell Phone/Teléfono celular *
Your answer
Email/Correo electrónico *
Your answer
Areas of Interest (students may only enroll in one course per session) *
Required
How would you describe your level of ability? *
For Music Students, select area of interest:
For students playing an instrument, what instrument do you play?
Your answer
For Dance Students, select area of interest:
For Theatre and Film Students, select area of interest:
For Visual Art Students, select area of interest:
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