Education Registration

Parent/Guardian First Name: Parent/Guardian Last Name: Parent/Guardian Email: Day Phone: Evening Phone (if different from day phone): Address: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Zip: - Zip Suffix Number of Students Attending: What best describes your child's race or ethnic origin? African-American Asian Caucasion Hispanic or Latino Middle Eastern Native American Other Prefer not to answer Which best describes your family's annual income before taxes? Under $25,000 $25,000-$49,000 $50,000-$99,000 Over $100,000 Prefer not to answer How did you hear about us? If you have a coupon, please enter code here (case-sensitive):