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* 1. Name?

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* 2. Grade:

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* 3. What high school do you attend?

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* 4. Contact Information:

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* 5. Parents/Guardians, if attending:

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* 6. Parent/Guardian Contact Information, if attending:

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* 7. Check the pathway(s) that most interests you:

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* 8. Sessions (check only 3):

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* 9. Email (Please provide to receive schedule):

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