New Student Registration
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent or Guardian (if under 18)
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
School or organization your affiliated with?
*
Who referred you to Project Real Solutions Program?
This Program is an 12 week program, classes will be 2 times a week(Monday & Wednesday for 2 hours). Can you commit to this schedule?
*
Yes
No
Why do you want to enter this program?
*
At the end of the program, what do you expect to have learned/gained?
*
Do you have any health issues we should know about?
*
What goals would you like to focus on in this program?
*
Improving Communication Skills
Personal and Financial Awareness
Career opportunities
Real Estate Skillset
Wealth building skills
Community Connections
Support and Mentorship
Other
Is there anything else you’d like us to know?
I’d like to stay in touch with you! I promise to only send you emails regarding being a student of our program or information which will have value to you as a student.
Yes, I agree to be added to the email list and I understand I can unsubscribe at any time.
No, I do not want to be added to the mailing list.
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