Inventor's Lab: Build your Own Robot - Student Registration Form
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Name *
Student Email Address *
Student Mobile Number *
Currently studying in Class *
City *
State / Province *
Country *
School Name *
Parent’s/ Guardian Name *
 Parent's/ Guardian Mobile Number *
Parent's/ Guardian Email Address *
Tell us about an inspiration in your life? Can be an experience or a story or a person or a role model. (Max 200 words)
*
Why should we select you for the program?
*
Undertaking and consent by form users:-
I hereby confirm that the information provided in this form is true and correct. The application will be processed based on the details provided.

Learn with Leaders reserves the right to use this information to correspond regarding current and future programs.

Right to admissions reserved.
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