Tele-ASL Registration Information
Winter 2020 Session
Classes start February 2020
Caregiver First Name *
Your answer
Caregiver Last Name *
Your answer
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Birth date *
MM
/
DD
/
YYYY
Phone *
Your answer
Email
Your answer
First Name of Family Service Coordinator *
Your answer
Last Name of Family Service Coordinator *
Your answer
Select Tele-ASL class level *
Level 1 is a pre-requisite to all other classes
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