Please fill out the following form to sign up for a class or an academy. The form must be filled out entirely or will not be accepted. If you have any questions please contact Matt Widaman at 907-283-2166 or email at mwidaman@kpbsd.org.
Class/Academy Interested In:

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* 1. Class/Academy Interested In:

Location of Class/Academy:

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* 2. Location of Class/Academy:

Your First and Last Name:

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* 3. Your First and Last Name:

Contact Phone Number:

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* 4. Contact Phone Number:

Your Cell Phone Number:

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* 5. Your Cell Phone Number:

Your Email:

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* 6. Your Email:

High School you Attend:

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* 7. High School you Attend:

Grade Level:

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* 8. Grade Level:

Student ID#:

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* 9. Student ID#:

Date of Birth

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* 10. Date of Birth

Date / Time

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