Community Extension Program - Since 1970. Logo designed and provided by CEP
(Part 1 of 2)
PLEASE NOTE:
All information must be completed and
submitted in less than 10 minutes
Students Last Name
First Name
MI
Parents/Guardians
Home Phone
Grade Entering in Fall
 
Students Home School 
 
Father Wrk Ph
Father Cell Ph
Mother Wrk Ph
Mother Cell Ph
Mailing Address 
City
State
Zip Code
 


June 2 - June 13

   If class is [Full] call for seat availability
Period 1     
Period 2     
Period 3     
Period 4     

June 16 - June 27

Period 1   
Period 2   
Period 3   
Period 4   

July 7 - July 18

Period 1   
Period 2   
Period 3   
Period 4   

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