dreaM Endlessly Summer Leadership Academy Registration
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Student Information
Name
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Address
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Phone Number
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Email Address
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Grade Level
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6th Grade
7th Grade
8th Grade
Current GPA
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Extracurricular Activities
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Essay: What are the traits of an outstanding leader?
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Parent/Guardian Information
Parent/Guardian Name
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Parent/Guardian Address
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Parent/Guardian Work Number
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Parent/Guardian Cell Number
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Emergency Contact Information
Different from Parent or Guardian
Emergency Contact Name
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Emergency Contact Number
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Medical Information
Physician Information
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Medications
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Allergies (Food/Seasonal/Etc.)
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