Washington D.C. Registration Form
Student and Chaperone Registration for the 2018-2019 Washington D.C. Trip
Email address *
Student ID Number *
Your answer
Last Name *
Your answer
First Name *
Your answer
Middle Name *
Your answer
Male/Female *
This is for rooming purposes only.
Student/Chaperone *
Date of Birth *
MM
/
DD
/
YYYY
Social Security Number *
This is required for the possible White House tour (XXX-XX-XXXX)
Your answer
Country of Citizenship *
This is required for the possible White House tour.
Your answer
Country of Origin *
This is required for the possible White House tour.
Your answer
Address *
Your answer
Student Phone Number *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Phone Number *
Your answer
Parent/Guardian Email *
Your answer
Requires Gluten Free Dining *
Requires Vegetarian/Vegan Dining *
Medication Required *
If "Prescription", then additional paperwork must be completed with a doctor's signature. If "Over the Counter", then additional paperwork must be completed
Room Accommodation *
Sweatshirt Size *
Homeroom Teacher *
Chaperones - the homeroom teacher for your child.
Math Teacher *
Chaperones - the math teacher for your child.
Language Arts Teacher *
Chaperones - the language arts teacher for your child.
Science Teacher *
Chaperones - the science teacher for your child.
Social Studies Teacher *
Chaperones - the social teacher for your child.
Behavioral/Expectations Contract *
Do you agree to the Student Behavioral Contract OR the Chaperone Expectations Contract?
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