On-Line Registration

First Name**
Last Name**
Address
City
State
Zip
Email address**
Parent of Special Needs Child? NO FEE	Yes No
Foster Parent? NO FEE	Yes No
Service Provider or Teacher? $30.00 fee	Yes No
New Hanover County Teacher NO FEE	Yes No
Do you want to attend the Poverty Simulation Workshop? NO EXTRA FEE	Yes No
Do You Want Lunch?	Yes No
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