SCC Program Registration
Welcome to Syracuse Community Connections! Our mission is to work with individuals, families, and communities to promote health and well-being through prevention, intervention, and education. Please register bellow to begin enjoying our services. 
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Participant First Name (for individual participating in program) *
Participant Last Name   (for individual participating in program) *
Date of Birth *
Parent/Guardian First Name ( Please type N/A if not applicaple) *
Parent/Guardian Last Name  ( Please type N/A if not applicaple) *
Street Address  *
City *
State *
Zip Code *
Phone Number *
Email *
Which program are you registering for? *
Would you require transportation assistance? (Specific to certain programs) *
Would you require food assistance?  (Specific to certain programs) *
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