Thank you for completing this application form to help insure a good fit.
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What is your child's name?
What is her or his age and grade level?
What interests you in having your daughter or son participate in M:POWERED 's unique personal development program?
Which of the following would you like to see you teen increase:
What concerns do you have for teens today?
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What city do you live (if Orlando, tell me which area)?
Does your child have any physical, mental or health conditions or challenges?
What else would you like to me know?
Thanks, Mom or Dad, What's your name & cell phone number?
To ensure that I receive this application right away, please text me now "MP Application Sent!" to 407-375-3404 I will reply to the cell you provided above within 24 hours. I look forward to working with you and your child. Krista Inochovsky
Class size is limited! If you have immediate questions, call or text Krista 407-375-3404.
A copy of your responses will be emailed to the address you provided.
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