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For Schools
Literacy Lab: Registration
Please fill out the following registration. Payment form will follow.
Classroom Teacher’s Name:
*
Contact Email:
*
Confirm Contact Email:
*
Cell:
*
Classroom Phone:
*
Students’ age range:
*
School/Site:
*
Site Director/Principal’s Name:
*
I certify that I will obtain my principal/site director’s permission before the program begins. I will let them know that the teaching artists in my classroom have a fingerprint clearance card. *
YES
NO
Do you have an assistant teacher joining you?: *
YES
NO
Assistant Teacher Name:
Assistant Teacher Email:
Confirm Assistant Teacher Email:
Date of your last day of school:
*
Time that your school day ends:
*
Where are you located?
*
East Valley
West Valley
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