Candy Elite Virtual Learning Center Registration Form
Please complete this form as accurate as possible to register your child for our Virtual Learning Center.
ONE FORM = Student. If siblings are registering, there must be a form completed for each child.
Email address *
Student's First Name *
Student's Last Name *
Birthdate *
MM
/
DD
/
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Grade *
School Name *
MEDICAL AWARENESS (asthma, allergies, health conditions, etc) *
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