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Dreamlearners Application
Dreamlearners Application
Date Requested (Option #1)
*
Date Requested (Option #2)
*
Date Requested (Option #3)
*
Do you want to attend in-person or virtually?
*
In-Person
Virtual
Preferred Time
*
Note: On-site DreamLearners sessions can only be hosted 9:30-11:30 a.m.
Name of School
*
School Address
*
Street Address
Address Line 2
City
State
ZIP
Is your school public or private?
*
Public
Private
Is your school a Title I School?
*
Yes
No
Point of Contact Name
*
First
Last
Contact Email
*
Contact Phone Number
*
How many students will you have?
*
Please enter a number from
15
to
63
.
How many adults will you have? (min. 2 per 10 youth, max. of 10 total)
*
Please enter a number from
2
to
10
.
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