Registration Form

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Registration Form

Please complete all fields on the form. Once your registration has been reviewed and approved, you will receive an email confirmation. If you have any questions, please send email to kseow@mail.fresnostate.edu

The email provided below is where the copy of your registration will be sent to.

电子邮件地址 *

Student Information

First Name
*

Last Name
*

Email Address (please DO NOT use your student email address)
*

Grade (for the 2022-23 school year)
*

其他:

Gender
*

Male

Female

Other

Decline to State

Ethnicity/Race
*

American Indian

Asian

African American

Hispanic

Native Hawaiian or Other Pacific Islander

White, Non-Hispanic

Multi-Racial

Other

Decline to State

School Name
*

School District
*

T-Shirt Size
*

其他:

If a friend referred you, what is his or her name?

Parent/Guardian Information

Parent Name (First Last)
*

Parent Address (street, city, zip)
*

Parent Phone (000-000-0000)
*

Parent Email Address (cannot be the same as student email)
*

您回复的副本将通过电子邮件发送到您提供的地址。

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