Barnabas Robotics New Student Survey
Interested in a class?  Let us know how we can serve you!
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Email *
First Name *
Last Name *
Phone # *
What is your zip code? *
What is your child's age? (Select more than one if you have multiple kids) *
Required
Which are you interested in?  (Check all that apply)
What type of school is your child enrolled in? (Check all that apply)
Describe your child's robotics experience (Check all that apply)
When is your child available for classes? (Check all that apply)
9 AM - 12 PM
12 PM - 3 PM
3 PM - 6 PM
Monday
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Wednesday
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Sunday
How did you hear about us?
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Anything else that you would like us to know?
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