Minnesota Excellence in Learning Academy
Student First Name *
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Student Last Name *
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Student Birthdate *
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Student Gender *
Grade Level Starting Fall of 2019 *
Parent/Guardian First Name: *
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Parent/Guardian Last Name: *
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Parent/Guardian Phone Number: *
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Street Address *
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City *
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State *
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Zip Code *
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Mother/Guardian Email Address
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Father/Guardian Email Address
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How did you hear about MELA?
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