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* Indicates required question
Email
*
Your email
Name (Last, First)
*
Your answer
Grade (The one your are going to be in next year 2019-2020)
*
10th
11th
12th
Phone #
*
Your answer
Is the number you listed yours or parent's?
*
Choose
Your Phone #
Parent's Phone #
Physical Address (Street, City, ST, Zip Code)
*
Your answer
Mailing Address (Street, City, ST, Zip Code)
*
Your answer
Are you enrolled in an Agricultural class for the upcoming school year? (2018-2019)
*
Yes
No
No, but I would like to be
If you are enrolled in an Agricultural class for 2018-2019, which one?
Animal Science
Advanced Animal Science
Equine Science
Veterinary Assistant
Plant & Soil Science
Do you have a job?
*
Yes
No
If you have a job, where do you work? (This can count for your summer ag credit!)
Your answer
Send me a copy of my responses.
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