MIC WEEKEND SCHOOL REGISTRATION & SURVEY FOR 2020 - 2021

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* 1. Family number (if known)

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* 2. Are you planning on enrolling your child/children in the MIC Weekend School Distance Learning Program? Note: This will require the use of Zoom teleconferencing technology. Tuition will be free, with only book expenses required up front.

Yes

No

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* 3. If not, why? Please type your reason(s) into the box below.

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* 4. Please enter your contact information below

Name

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

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* 5. Please enter full names and ages corresponding to each child you are planning to register.

Student 1

Student 2

Student 3

Student 4