Acquiring Socialization Skills through Acting and Drama

Registration

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Register on-line or by mail:
 
 

Parent Name(s):
Address:
City/State/Zip:
Home Phone:
Work Phone:
Fax:
E-mail:
Cell Phone:
Child's Name:
Child's Age:
Child's Grade:
School:
IEP?
504 plan?
Special needs or considerations:
Socialization goals from IEP or 504 plan:
Emergency contact:
  

Printable Registration Form

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Looking forward to seeing you!!!

(c) 2005 Claudia Lowe, Special Educational Needs Consultant