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We are thrilled by your interest in our program!
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Student First name
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Student Last name
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Parent's Email
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Phone
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Student Birthday
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Month
Day
Year
Multi-line address
Country/Region
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Address
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City
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Zip / Postal code
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Select the Program you're registering for
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AFTER SCHOOL
PRIVATE TUTORING
NY STATE TEST PREP.
SUMMER CAMP
FOR all students, Let us know about updated ALLERGY list/ or other medical/behavior information IKLASS should be aware of about your child. IF NONE/ PUT "NONE"
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Select ONE
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MY CHILD IS A RETURNING STUDENT
MY CHILD IS A NEW STUDENT
SCHOOL NAME
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GRADE LEVEL IN SEPTEMBER 2025
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NEED SCHOOL PICK UP?
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IF YES** Teacher's Name / Class # IF NO** put "DO NOT NEED PICK UP"
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Emergency Contact Person FULL NAME
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Relationship to the child
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Tel #
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Additional Emergency Contact Person FULL NAME
Relationship to the child
Tel #
Submit
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NY State Prep
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