PREP Registration Form

Course Registration & Interest Form

All genders & identities welcome.
Upcoming classes:

*Coming soon*

Ps: If you are under 18 years old don't forget have a parent/guaridan sign the required consent form.
Full name: *

First Name Last Name
Preferred name/nickname:

First Name Last Name
E-mail: *
Pronouns *

He/Him/His She/Her/Hers They/Them/Theirs
Phone number:

Area Code Phone Number
Age: *
Date of Birth: *
I am interested in:

Attending a PREP course as a student in PREP coming to my organization
Preferred language:

English Spanish
I attend:

Manchester West High School Manchester Memorial High School Manchester Central High School Manchester School of Technology Home School I am not in high school and/or do not attend school.
How would you like to be contacted?

Email Call Text
What date(s) do you want to join? *
Are you seeking ELO credit?

Yes : Please make sure to have registration, consent and ELO form completed before class starts No
Were you referred by a friend? If so who can we thank?
If you are wanting ELO credit, fill this form in to make sure your ELO coordinator knows

Click this link

ELO form
Should be Empty:

Course Registration & Interest Form