Computer Mentors Registration Form

Contact Information - Step 1 of 3
Please enter student first name.
Please enter student last name.
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Please enter student's birth date (mm/dd/yyyy)
Please choose gender.
Select your school.
Please type the name of the person/organization that encouraged you to enroll. ( If no one did, type "N/A" )

New registrations are for next 9-week class session, starting January 10th.
Please enter student cell phone number
Please enter student email address