Life Curricula Interest Form

I am interested in the following course dates:(Required)
Name(Required)
Home Address(Required)
MM slash DD slash YYYY
Can we text you at this number?(Required)
Do you check this email regularly?(Required)
Highest Education Level Completed
Do you need childcare? (Offered ages 2-12) Select Yes or No:(Required)
Do you have access to transportation?(Required)
Do you have any food allergies?(Required)
I am interested in the following courses: (select all that apply)(Required)
First Choice ( Select One):(Required)
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Second Choice ( Select One):(Required)
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