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Workshop Registration/Registro del Taller
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* Indicates required question
Parent/Adult First Name & Last Name : Nombre y apellido del padre/adulto
*
Your answer
Phone # / Numero de Telefono
*
Your answer
Email / Correo Electronico
*
Your answer
Student Name / Nombre del Estudiante
*
Your answer
Grade / Grado
*
9
10
11
12
12+
Required
Student ID (if available) / #ID de estudiante (si está disponible)
Your answer
What workshop & days will you attend? / ¿A qué taller y días asistirás?
*
Oct 25th at 8:30am - Parent Focus Group /
Oct 25 9am - Breast Cancer Awareness & Toxic Substances /
Nov 29th at 9am - Mental Heath /
Jan 24th at 9am - Substance Abuse in Youth /
Feb 28th at 9am - Healthy Relationships Feb 28th at 9am /
Option 6
Required
What topics would you like to see in the future? / ¿Qué temas le gustaría ver en el futuro?
Your answer
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