Collegiate Learning Registration Form
Use this form to register for Collegiate Learning Courses. Please complete it entirely.
Email *
Parent Name
Parent Phone (for use in case of emergency contact only)
Student Name
Student Email (for the Canvas Classroom)
How did you find out about this class?
Student Date of Birth (Class is for high school students)
MM
/
DD
/
YYYY
Student Grade in 2020-2021 School Year
Classes *
Required
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