NHS Learning Center Registration Form
Please complete this registration form in order to register for the NHS Learning Center. Please complete a separate form for each student that will be attending.
STUDENT FIRST NAME *
STUDENT LAST NAME *
GRADE *
PARENT 1 *
PARENT 1 EMAIL ADDRESS *
PARENT 1 PHONE NUMBER *
PARENT 2
PARENT 2 EMAIL ADDRESS
PARENT 2 PHONE NUMBER
NUMBER OF DAYS YOUR CHILD WILL ATTEND
DROP OFF TIME
Time
:
PICK-UP TIME
Time
:
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