Personal Information Form
Please complete the following information about yourself. Any information shared will be kept private.
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Course code *
Last Name *
First Name *
Your Email Address *
Guardian1  Full Name *
Guardian 1 Phone number *
 Guardian 1 Name Email Address   *
Guardian 2 full Name
 Guardian 2 Phone number
Guardian 2 Email Address  
What are your goals for this course ? *
What is one thing you would like to learn during this course ?  *
Do you have any questions ?
Is there anything else you would like to share about your self?
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