Name: _____________________________________
Address: ___________________________________
___________________________________
Date of Birth: __________ Grade 6 7 8 9 10 11 12
Emergency Contact: __________________________
Emergency Phone: ____________________________
School Attended 2004-2005 School Year:
___________________________________________
School Phone: _____________ School Fax: ________
Course(s) Needed: ____________________________
Sessions Attending:
Session 1 _______
June 5 – June 16
|
Session 2 _______
June 19 – June 30 |
Session 3 _______
July 3 – July 14 *
|
Session 4 _______
July 17 – July 28
|
Each Session is 67 ½ Hours and Equal to 1 Semester
* - 4 th of July will force extended hours to Honor the Holiday . |