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FieldLEARNs 2021-2022 Program Application
$25 non-refundable registration fee* due prior to enrollment. (Check or money order made payable to PUSD. No cash accepted.)
*Registration fee waived for students who qualify for free/reduced lunch.
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了解详情
* 表示必填
电子邮件地址
*
您的电子邮件
Student Information
Student Last Name
*
您的回答
Student First Name
*
您的回答
Gender
*
Male
Female
Non-binary
Prefer not to state
Date of Birth
*
年
/
月
/
日
Race/Ethnicity
*
Decline to State
Asian
Hispanic or Latino
Black or African American
White
Middle Eastern
Multiracial
Native Hawaiian or Pacific
American Indian or Native American
其他:
Grade in Fall 2021
*
选择
K
1
2
3
4
5
6
7
8
Student ID#
您的回答
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此表单是在 Pasadena Unified School District 内部创建的。
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表单
