G9 S.T.E.P. Registration
PLEASE NOTE: Only students attending 9th grade at Willingboro High School September 2024 are eligible for this program.
Student's Name
*
First Name
Last Name
Student's Gender
*
Male
Female
Prefer Not to Say
Gender Pronouns
He/Him
She/Her
They/Them
Other
Student's Age
*
13
14
15
Other
Student's Date of Birth
*
-
Month
-
Day
Year
Date
Please List Any Allergies
Student's Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Email
*
example@example.com
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Submit
Should be Empty: