RESERVE YOUR SPOT FOR 7TH GRADE CHALLENGE DAYS!
Student Information
Student First Name *
Preferred Name
Student Last Name *
Suffix
Student Date of Birth
(mm/dd/yyyy)
School
Parish/Church
Student Address
City
State
Zip Code
Parent Information
Parent/Guardian Name *
Parent Cell Phone *
(In case of emergency)
Parent E-mail *
Challenge Days Information
Preferred Challenge Day Date *
Favorite Academic Subjects
Co-Curricular Interests
(Fine & Performing Arts, Athletics, STEM, Clubs/Organizations, etc.)
Additional Notes
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