Thank you for your interest in the 2026 Level Up Bootcamp provided by Florida State College at Jacksonville and JAXUSA Partnership! More information to come regarding registration.

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* 1. Student Name

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* 2. Parent/Guardian Name

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* 3. Second Parent/Guardian Name (If Applicable)

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* 4. Home Address

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* 5. School

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* 6. Grade Level

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* 7. Student Email

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* 8. Parent/Guardian Email

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* 9. Second Parent/Guardian Email (If Applicable)

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* 10. Student Phone Number

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* 11. Parent/Guardian Phone Number

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* 12. Second Parent/Guardian Phone Number (If Applicable)

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* 13. Career Pathway Interest

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* 14. Indicate which camp you are interested in attending:

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* 15. If you are open to either camp date, please rank them by first and second choice:

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* 16. There is a $25 dollar fee for this camp when registering with FSCJ. If you believe this may cause a hardship for you, please let us know.

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* 17. Did you hear about the Level Up camp from a student who attended the camp last year?

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* 18. If so, please provide the students name.

Thank you for filling out this survey! The Level Up team will be in contact with you soon.

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