Galileo Online Learning Premium Free Trial Registration Form

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Email *

Name of Parent/Guardian *

Name of Child *

Date of Birth (MM/DD/YYYY) *

Age *

Contact number *

Are you a New, Returning, or an Existing student? *

New student

Returning student

Existing student

City of Residence *

Grade level *

Subject for the Galileo Online Learning free trial *

Preferred mode of communication *

Cellphone number (Phone Call or Text message)

Facebook Messenger

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How did you know about Galileo? *

Social Media (FB, IG, Twitter)

Referred by a Friend

Referred by a Teacher

Website

Other:

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This form was created inside of Sacred Heart School.