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Regional Scholars Adult Contact Form
Please complete if you are attending Regional Scholars or pass on to the adults who will accompany students from your school district.
* Indicates required question
Email
*
Record my email address with my response
Name
*
Your answer
Cell Phone Number - 740-555-5555 format please
*
Your answer
Email
*
Your answer
School District
Your answer
All my students will be doing the following? Check the one that works for all your students.
Attending only the 1st day of the leadership camp and not staying the night.
Attending only the 2nd day of the leadership camp.
Attending both days of the leadership camp but not staying the night.
Attending both days of the leadership camp and staying the night.
Other:
T-Shirt Size
*
Choose
Small
Medium
Large
X-Large
XX- Large
XXX-Large
A copy of your responses will be emailed to .
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