Summer Math Assessment Prep Academy
Registration Form
Student Name *
(First Name, Last Name)
Your answer
Are you a High School student? *
What school do you currently attend? *
(Please list current High School or College)
Your answer
Are you currently taking a math class? *
If yes, what math class are you currently enrolled?
Your answer
If not currently enrolled in math, please list the highest level completed *
(please list below)
Your answer
Student E-mail Address *
Your answer
Student's Phone Number *
Your answer
Parent Name
(if under 18 years of age)
Your answer
Parent Phone Number
(if under 18 years of age)
Your answer
Parent E-mail Address (if known)
(if under 18 years of age)
Your answer
Winter Math Assessment Prep Academy *
Please choose which session you would like to attend (all sessions are Monday, July 16th - Thursday, July 19th)
Who should we contact in case of emergency? *
Your answer
Emergency Contact Phone Number *
Your answer
Reasonable accommodation will be provided to facilitate the particpation of covered individuals with disabilities. *
Will you need these services?
Submit
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