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CK Referral Program Form - CK
1
Student's Name
*
This field is required.
Who are you referring to?
First Name
Last Name
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2
Parent's Name
(We need this only if the student is a minror)
First Name
Last Name
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3
Phone Number
*
This field is required.
(Please provide phone number of the parent, if the student is a minor)
Area Code
Phone Number
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4
Email
*
This field is required.
(Please provide email of the parent, if the student is a minor)
example@example.com
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5
Do you have any notes for us?
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Ok
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6
Your Name
*
This field is required.
First Name
Last Name
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7
Your Email
*
This field is required.
example@example.com
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8
Your Phone
*
This field is required.
Area Code
Phone Number
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9
Are you a student at Chess KLUB?
*
This field is required.
YES
NO
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10
Do you love Chess? Would you like to learn Chess?
*
This field is required.
YES
NO
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11
Consent
*
This field is required.
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