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* 1. First Name

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* 2. Last Name

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* 3. School Email Address

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* 4. Summer Email Address

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* 5. School Division

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* 6. Name of School

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* 7. School Street Address

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* 8. School City, State, Zip Code

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* 9. School Phone Number

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* 10. Home Phone Number

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* 11. What course are you registering for?

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* 12. What course do you teach?

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