STUDENT'S INFORMATION
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First Name *
Last Name *
Student ID (OSIS #)
Gender *
Ethnicity *
DOB *
MM
/
DD
/
YYYY
Grade *
Current School *
Area of need *
What Program/Who referred you to NYMACS?
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PREFERRED PROGRAM
Academic Support
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Test Prep (test prep meet on Saturdays only). Choose all that apply
Homework Help schedule
3pm-4:30pm
5pm-6:30p
Monday
Tuesday
Wednesday
Thursday
Friday
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1-one-1 schedule
10am-10:55am
11am- 11:55am
1pm-1:55pm
2pm-2:55pm
3pm-3:55pm
4pm-4:55pm
5pm-5:55pm
6pm-6:55pm
Monday
Tuesday
Wednesday
Thursday
Friday
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Test Prep Schedule
10am-1pm
2pm-5pm
Saturday
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