Sequoyah Summer Bridge Program Registration (Inscripción al Programa de Verano para los que Entran a 6to grado)

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Please fill out this form to register your student for our Summer Bridge Program. Make sure to fill out the form in its entirety. / Complete este formulario para registrar a su estudiante en nuestro programa Summer Bridge. Asegúrese de completar el formulario en su totalidad.

Student Last Name (Apellido del estudiante)

Student First Name ( Nombre del estudiante)

Select the date(s) that your student will attend the program ( Seleccione la(s) fecha(s) en que su estudiante asistirá al programa)

July 10-14 (Monday -Thursday)

July 17-20 (Monday-Thursday

Both July 10-14 and July 17-20

Other:

Student "S" Number/Lunch Number ( Número de estudiante "S" or lonche )

Name of Elementary School (Nombre de la escuela primaria)

Oakcliff ES

Dresden ES

John Lewis ES

Cary Reynolds ES

Montclair ES

Woodward ES

Doraville United ES

Other

Other:

Student Address (Dirección del estudiante)

Parent Name (Nombre y apellido del padre o madre)

Parent Phone Number (Numero del telefono del padre o madre)

Transportaion (Transporte)

Bus (bus escolar)

Car Rider (por carro)

Walker (camina a la escuela)

Submit

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