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* 1. First & Last Name

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* 2. Phone Number

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* 3. E-mail Address

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* 6. Grades currently represented within your household (Please check all that apply)

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* 7. What subjects/topics would you like to see covered? (Please check all that apply)

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* 8. Please feel free to share any questions you may have or let us know if there are any particular resources that you would like to know more about.

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