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Registration

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   Personal Information
     
       
Name:
     
Home Address:
     
Zip Code:
     
Home Phone:
     
Work Phone:
     
Cell Phone:
     
E-Mail:
     
 
  Parent or Tutor
       
  Emergency Contact Information  
       
Emergency Contact Name:
     

Emergency Contact Phone:

     
       
  Are you a parent/guardian/tutor of a student registered in a M-DCPS school?  
       
Type yes or no :
     
List students by name & school:
 
 
Register for Classes
 
List classes: 
 
 
 
 
 
 
 
     
 
 this form and Fax to 305-523-0505

 

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