NOTE: Enter Parent/Guardian Information below. If entering a secondary contact during registration, a "Copy Address From Primary" button is displayed. Clicking on this button will copy address from your Primary contact information (use this when parents have same address). Click on OK when finished. Account Information
First Name: * MI: Last Name: *
Address Line #1: *  
Address Line #2:
City: *  
State: *  
Zip: *  
For phone numbers enter only numbers (i.e. 6365121111)
Home Phone: *    
Mobile Phone:    
Work/Alternate Phone:   Ext.  
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