BEC-TV Tech Profile Form
This is our official signup form! It does not obligate you to anything, nor cost you anything. It just helps us collect some important contact info for our newest Student Tech and their family.

For the Email box below, please enter your preferred email to receive production invites and information. If you want multiple emails to receive these invites, please let us know in the Questions/Comments section on the last page of this form. We're glad to send to both a student and parent email if you'd like, and you can always change that later-- just let us know.
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Email *
First and Last Name *
Birth Date *
MM
/
DD
/
YYYY
Gender
Clear selection
Address *
Home Phone Number
Cell Phone Number *
Current School *
High School
For Middle Schoolers- what high school do you anticipate going to?
Grade *
Graduation Year
Clear selection
Next
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This form was created inside of Bloomington Public Schools.

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