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Humble Christian School - CODEXCEL Afterschool Prgm Interest Form
Student's First name
*
Student's Last name
*
Student's Birthday
*
Month
Month
Day
Year
Student's Gender
*
Male
Female
Student's Grade
*
4th
5th
6th
Parent's/Guardian's Name
*
Parent's/Guardian's Email
*
Parent's/Guardian's Phone
*
What are your Best Days for CODEXCEL Afterschool Program (3:30 - 5:30PM)
*
Monday/Wednesday
Tuesday/Thursday
Submit
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