Thanks for registering for school year weekly time slots for 2024-25!

To register, please complete this registration form and we will be in touch with scheduling and enrollment information.

Questions? Please feel free to email us at info@greenivyed.com.

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1. Student(s) Name(s) (Last, First) (Required.)

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2. Parent Name (Last, First) (Required.)

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3. Phone Number (Required.)

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4. Email Address (Required.)

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5. Name of School and Grade Level (Required.)

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6. Desired Number of Time Slots Per Week (Required.)

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7. Staff Member Preference (if any)

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8. Desired Days/Times of Week (*please list several options) (Required.)

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9. Are you hoping for in-person or virtual instruction? (Required.)

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10. Subjects to be Prioritized/Special Requests/Comments (Required.)

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