Please complete one form for each child.

Name of school your child attends:

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* 1. Name of school your child attends:

Student's grade level:

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* 2. Student's grade level:

Student's last name:

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* 3. Student's last name:

Student's first name:

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* 4. Student's first name:

Last name of parent/guardian for listserv:

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* 5. Last name of parent/guardian for listserv:

First name of parent/guardian for listserv:

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* 6. First name of parent/guardian for listserv:

Email address for listserve:

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* 7. Email address for listserve:

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