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Achievement Track & Community Circles
Semester Registration Form
In order to register for this Achievement Track, you MUST attend an info session to learn more about the track eligibility and requirements.
Please select ONE day and time you are available to attend the Info Session:
How Did You Hear About University for Parents?
Select Referral
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First Name
Email
Primary Phone
Are you a New/Returning Parent Learner?
New
Returning
Last Name
Date of Birth
Alternative Phone
What is Your Gender?
Choose an option
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What is Your Ethnicity?
Choose an option
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip code
What County Are You In? (GA Only)
Choose a County
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Employment Status
Choose an option
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Do you receive SSI/SSDI benefits?
Choose an option
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What is Your Relationship to the Child/ren?
Choose an option
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Do You Have a Computer/Laptop?
Yes
No
Emergency Contact Full Name
Income Level
Choose range
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Are You Parenting Children Under 18?
Choose an option
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What are the Ages & Genders of Child/ren?
Are You a Registered Voter?
Yes
No
Emergency Contact Phone
Is There Anything You Wish to Share That Has Not Been Asked?
Which Achievement Track Are You Registering For?
Digital Technology - Tuesdays (6:00pm - 8:00pm)
Intro to Microsoft 365 - Wednesdays - (6:00pm - 8:00pm)
Early Learning Career Pathway - Wednesdays - (6:00pm - 8:00pm)
Workforce Development - Wednesdays - (6:00pm - 8:00pm)
Financial Literacy & Sustainability - Wednesdays - (6:00pm - 8:00pm)
Which Community Circle Are You Registering For?
Wellness Circle - Tuesdays (10:00am - 11:00am)
Parenting Circle - Tuesdays - (6:00pm - 7:00pm)
Wellness Circle - Thursdays - (6:00pm - 7:00pm)
Parenting Circle - Thursdays - (6:00pm - 7:00pm)
Waiver and Release of Liability: I agree that the information I included is true and I am committed to my success with the university. I give the National CARES Mentoring Movement/University for Parents permission to use photos and the likeness of myself and my children image in print, electronic, and visual format. I also give permission to share data about my participation in the university with all its partners for educational assessment, and evaluation purposes. I release from liability and waive my right to sue National CARES/University for Parents/Atlanta CARES, their employees, independent contractors, and officers, volunteers and agents from any and all claims, including claims of the negligence, resulting in any physical injury, damage to my personal property, illness (including death) or economic loss I may suffer or which may result from my participation in the program. I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY, AND I FULLY UNDERSTAND ITS TERMS
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