EmailMe Form - UBMS 2024-2025 Academic Year (AY) Program

Name *

First Last

High School *

Grade in 2024-2025 *

STUDENT Cell Phone *

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STUDENT Email *

Academic Year Program Participation *

I will be participating in the AY Program this year.

I will only be able to participate in the Fall Senior Bootcamp (SENIORS ONLY)

I will not be participating in the Program this year. (Reason)

T-shirt size *

Do you have any potential conflicts on Saturdays during the AY program? If so, please explain below. *

Yes

No

Potential Saturday Conflicts (please include date and time if you know already)

COMPLETE ONLY IF YOUR ADDRESS HAS CHANGED SINCE LAST YEAR.

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

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