Campus Life Registration - 2018/2019
Student Name (First & Last) *
Your answer
Student Birth Date *
MM
/
DD
/
YYYY
Grade Level *
School County *
School Name *
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Student Cell
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Parent/Guardian Name *
Your answer
Parent/Guardian Address (Please list Street, City, State & Zip Code) *
Your answer
Parent/Guardian Cell *
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Parent/Guardian Email *
Your answer
I would like to subscribe to the weekly Connection email list. *
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