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NOTE: Please click the Submit button only once. It will take a few seconds to process and then you will receive a confirmation message.
I am interested in enrolling a student(s) in a course that is not currently posted on the schedule. |
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Yes |
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| If yes, which course? Choose as many as appropriate by holding down the "control" key as you click multiple selections: |
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| I am interested in courses at the following locations. Choose as many as appropriate by holding down the "control" key as you click multiple selections. |
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| Interested in setting up a specific course for a group of 8-12 students |
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Yes |
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| How many students? |
Ages 5-7:
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Ages 8-14
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| * Father's First Name: |
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| * Mother's First Name: |
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| * Last Name: |
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| * Email Address: |
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| * Mailing Address: |
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| * City : |
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| * State: |
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| * Zip Code: |
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| * Telephone: |
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| * Cell Phone: |
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| Please list each student's name and birthdate |
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| I represent a School, Organization, or group interested in offering Logical Learning Lab courses at our facility |
No
Yes
If yes, what group do you represent?
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| Additional comments: |
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* Required
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NOTE: Please press the Submit button only once. It will take a few seconds for the form to process.
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