Aim High Academy, Inc. Online Registration

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Registration For 2024-2025 Classes Only!

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Zip*

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Additional Info

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Contact #1

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Student #1

Student's First Name*

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Student Gender*

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Additional Info

Student Email

T-Shirt Size

School

Grade Level

Transportation

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Primary Doctor

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Student #2 (Show-Hide Details)

Student's First Name*

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Student Gender*

Birth Date*

Additional Info

Student Email

T-Shirt Size

School

Grade Level

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Disabilities (Leave blank if NONE)

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Student #3 (Show-Hide Details)

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Student Email

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School

Grade Level

Transportation

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Medications (Leave blank if NONE)

Primary Doctor

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Student #4 (Show-Hide Details)

Student's First Name*

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Birth Date*

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

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Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

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Enroll in Classes

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Comments

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Exp Year *

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Name as it appears on card *

Address Line 1

Address Line 2

City

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Zip*

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

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Student #4 (Show-Hide Details)

Additional Info

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Student #5 (Show-Hide Details)

Additional Info

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