First Name:
MI:
Last Name:
Address Line 1:
Address Line 2:
City:
State:
Zip:
Phone:
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Email:
Parent Email:
Birth Date:
Permit # (optional):
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Please be specific.
Example:
John Smith
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LOCATION
:
North Reading High School
Paying Balance amount (I have previously paid the deposit)
Reading Office - 580 Main Street, Reading MA
Stoneham High School
Wakefield High School
Wakefield Office - 101 Albion Street, Wakefield MA
Wilmington Office - 474 Main Street, Wilmington MA
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SESSION
:
Click if billing address is same as above
Billing Address
City/Town
State:
Zip:
AMOUNT TO CHARGE
Program Fee
Pay in full OR
Deposit
(Balance due by day of first class.)
Balance Due
(I have previously paid the deposit.)
REQUIRED
:
Contract read and agreed to.
Click for printable contract.
Signed copy must be turned in the first day of class to complete enrollment.
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