Money Moves: Wise Up with EECU
Please complete the below form to Register for the youth financial literacy workshop hosted by The Atwater-Merced Alumnae Chapter of Delta Sigma Theta Sorority, Inc. EECU, Central Valley Community Foundation, and Panda Express.
Students Name
*
First Name
Last Name
Students Email Address
*
example@example.com
Students Mobile Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I accept SMS Text alerts to receive our latest news, reminders, and promotions. MSG frequency varies. I understand that my own mobile carriers may apply data rates. I can opt out at any time, by contacting the Youth Programs of Atwater-Merced Alumnae Chapter.
*
Yes
No
Name of School Student Currently Attends:
*
Students Current Grade
*
Student Age
*
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Mobile Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I accept SMS Text alerts to receive our latest news, reminders, and promotions. MSG frequency varies. I understand that my own mobile carriers may apply data rates. I can opt out at any time, by contacting the Youth Programs of Atwater-Merced Alumnae Chapter.
*
Yes
No
Emergency Contact that is not the listed above parent/guardian. Please provide their name and phone number.
*
Does the above minor child have any medical diagnosis we should be aware of such as but is not limited to health concerns, allergies, diabetes, epilepsy, etc. If so please list below. If not please put N.A.
*
Submit
Should be Empty: