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'Degrees B4 Diapers' Interest Form
Enrollment in Winter Session
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Email
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Your email
Applicant Name
*
Your answer
Age
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School
Your answer
Grade
Your answer
Why do you want your child to participate in this program?
Your answer
Parent must attend orientation. This might be done virtually. Do you agree to attend?
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Phone number
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Please list your child emergency contact including phone number.
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Your child must attend regularly to qualify for incentives.
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How did you hear about our program?
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Send me a copy of my responses.
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