W.I.U.F.C. - Word Force Program

W.I.U.F.C. Work Force Reading Program

Registration Form
Student's Name:*

First NameLast Name
Grade Level:*

Kindergarden1st Grade2nd Grade3rd Grade
Age:*
Gender:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student's Phone:*

Area CodePhone Number
Student's Email:*
example@example.com
Parent/Guardian's Name:*

First NameLast Name
Parent/Guardian's Phone:*

Area CodePhone Number
Parent/Guardian's Email:*
example@example.com
Does Student Have Access to a computer:*

YesNo 2
Does Student Have Internet Access?*

YesNo
Best Days for Class:*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Parent/Legal Guardian's Printed Name*

First NameLast Name
Parent/Legal Guardian's Signature:*

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Today's Date:*

MonthDayYear
Date
Should be Empty: