Little Ukers Grade 2/3 Waitlist 2021/2022
September 2021 - June 2022 Waitlist
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Student Name (1) *
First and last name please
What Grade Is Your Student In For The 2020/21 School Year? (1) *
What School Does Your Student Attend? (1) *
School District (1) *
Please indicate the district number of your school
Primary Contact Information
Please provide primary contact information for your student(s).
Parent Name
Full Name Please
Home Phone (Or Best Available) *
XXX-XXX-XXXX
Email Address *
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