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Plaza Comunitaria Northside Clases Computación
Forma de Registro Septiembre 2024 (Registration Form September 2024)
* Indicates required question
Email
*
Your email
Nombre y apellido
(Name and Last name):
*
Your answer
Fecha de nacimiento
(Date Of Birth):
*
MM
/
DD
/
YYYY
Género
(Gender):
Choose
Male/Hombre
Female/Femenino
Other/Otro
Dirección(Address):
Your answer
Número de Teléfono
(
Phone number):
*
Your answer
Contacto de Emergencia
(Emergency Contact):
Your answer
Clase
(Class):
*
Choose
Basic Computer Course/Curso Básico de Computación
Advanced Computer Course/Curso Avanzado de Computación
Horario (Time):
*
Choose
Morning/Diurno
Evening/Nocturno
¿Como se enteró del Curso? (How did you find out about the Course?)
*
Your answer
A copy of your responses will be emailed to the address you provided.
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