Launchpad for Success PRE-Registration Form 2020

LAUNCHPAD FOR SUCCESS 2020 - July 20 thru July 31

Online Pre-Registration - For youth grades 6th through 10th
Type a question
Student Information
Student's Name

First NameLast Name
Age
Birth Date

MonthDayYear
Grade
Grade entering for upcoming school year
T-Shirt Size
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student's Number

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

First NameLast Name
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
E-mail
Payment Policies: Tuition amount of $100.00 per week for each participant should be paid by cash, credit, or money orders payable to New Vision International Ministries. Tuition for the first week is required upon enrollment to secure registration. All other payments are required at the beginning of each week.
Will you have financial need for a scholarship? (If Yes, please explain)
What are you able to afford weekly?
IMPORTANT! All students need an updated physical form in order to participate in the program.
Please submit any questions you may have here:
Acceptance Policy:
LaunchPad for Success does not discriminate against age, sex, creed, color, religion, sexual preference or people with disabilities.
Confirmation

BY SUBMITTING THIS FORM I ACKNOWLEDGE THAT I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty:

LAUNCHPAD FOR SUCCESS 2020 - July 20 thru July 31