Exit this survey

TXT 2011 Application

Please complete this application for the TXT2011 event at Dakota County Technical College July 25-29, 2011.
You will be mailed a registration packet.

Registrations and payment must be received by July 8, 2011.

Question Title

* About the Student:

Name:

Grade in Fall 2011:

School Attending:

Birth date:

Question Title

* About the Parent:

Name:

Street Address:

City:

State:

Zip Code:

Email:

Home Phone:

Cell Phone:

Work Phone:

Question Title

* Student: Why are you interested in attending the Teens eXperiencing Technical Education 2011 program?

Question Title

* Parents: By completing this application, do you understand if your child is chosen to participate in the program that you will be responsible for transportation to and from Dakota County Technical College each day July 25-29?

Yes

No

Question Title

* Parents: By completing this application, do you understand if your child is chosen to participate in the program that you will be responsible completing registration and payment of the $25 fee by July 1, 2011?

Yes

No