Parent Academy Advanced Classes Registration
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First Name
Last Name
Zip Code
Phone Number
Email Address
What is the best way to reach you to provide you with information regarding Parent Academy?
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Name of your 4 year old child:
Does s/he attend preschool?
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Will you need child care services while attending class?
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For how many children?
Child care services are for children three years to 12 years of age only.
What are the ages of your children?
Does your child have any allergies or medical conditions?
If yes, please explain.
Are you a vegetarian?
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Are any of your child(ren) vegetarian?
If yes, please indicate the name of your child(ren) who are vegetarian below
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Please indicate which time of day would you prefer to attend class.
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Please indicate which session you would prefer to attend.
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Will you need assistance with transportation stipends?
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For information or inquiries, call: 323-299-9660 ext. 2247 or 2281 or email to:
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