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Student:
Name
Gender M F
Date of Birth (MM/DD/YYYY)
Home Address
Name of School
Grade this year
E-mail Address
Telephone Number
Parent:
Name
E-mail Address
Telephone Number
Choose Program:
Junior Excel (6th~8th) PSAT/SAT/ACT Prep (9th~12th)
College Consulting & Tour (9th~12th)
Camp Location:
UCLA UC Berkeley (not available) Stanford (not available)
Resident Commuter
Payment Options:
Check Wire
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Any Comments and Questions:
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