ECCA Inquiry Form 2023-2024
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Email *
Student FIRST Name *
Student LAST Name *
What School DISTRICT are you in? *
What GRADE are you currently in?  *
What is your PRIMARY email address? *Please enter a student district email address. *
What is your SECONDARY email address? *Please enter a personal email address.  *
What is your PHONE #? (Optional)
Please provide a PARENT/GUARDIAN EMAIL below.  *
What PROGRAM(S) are you interested in? *You can choose more than one if you would like.  *
Required
VIRTUAL INFO SESSIONS  will be held the evenings of Tuesday January 9th and Wednesday January 10th at 6:30PM. Please indicate your preferred day of attendance. You will receive an invite to the zoom links closer to the date of the sessions.  *
How did you HEAR about us? *Please use other to indicate a specific student, class, instructor, school district, or community member/business. You can choose more than one option.  *
Required
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