SAT/ACT Jump Start Camp
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Student First Name *
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Student Last Name *
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If student has an email address and would like to receive reminder emails, please enter here:
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Gender *
Class of *
School *
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GPA *
PSAT Reading/Writing
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PSAT Math
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Math class student will take in 11th Grade
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Dietary Restrictions
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If granted or seeking accommodations by College Board based on IEP or 504 plan, please list accommodations here:
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After-School Activities
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List Siblings who Have Taken Our Course
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Parent 1 First Name *
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Parent 1 First Last *
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Parent 1 Email Address *
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Parent 1 Address *
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Parent 1 City *
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Parent 1 Zip
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Parent 1 Phone (xxx-xxx-xxxx)
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Parent 2 First Name
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Parent 2 Last Name
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Parent 2 Email Address
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Parent 2 Phone (xxx-xxx-xxxx)
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Parent 2 Address (if different from Parent 1)
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Referred by
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How do you plan to pay for this camp?
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