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Request for On-site Class Enrollment
 
Student's name (First Last):
Class 1 of 6:
Class 2 of 6 (optional):
Class 3 of 6 (optional):
Class 4 of 6 (optional):
Class 5 of 6 (optional):
Class 6 of 6 (optional):
Grade level:
School:
Semester (Fall/Spring; Year):
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Credentialed Teacher/Educational Specialist: (Required for charter school students)

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