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Please enter the following details:
Student 1 First Name:
*
Student 1 Last Name:
*
Room No:
*
Student 2 First Name:
Student 2 Last Name:
Room No:
Student 3 First Name:
Student 3 Last Name:
Room No:
Parent Details:
First Name:
*
Last Name:
*
Email ID
*
Phone No:
*
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Checks are payable to Faria Educational Enrichment Fund.
Name on Check
*
Check No:
*
Date
*
Amount
*
Thank you!
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