HLCEP Student Registration 2019
Name of Student: *
Date of Birth: *
Age: *
Street Address, City, State, Zip Code: *
Are you enrolling more than one child from your household? *
If so, please list all sibling names, birthday, and t-shirt size you plan to enroll:
Home Phone: *
Cell Phone: *
Gender (Circle One): *
T-Shirt Size (Circle One): *
S
M
L
XL
Children's size:
Current School: *
Grade (for Fall 2019): *
Has this student attended the Hmong Language and Culture Enrichment Program in the past? *
Does this student receive free/reduced lunch at school? *
If "Yes" what year (Check the appropriate year):
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