EventKeeper : EK Form

1	Shrewsbury Public Library 2013/02/19 : Youth Vacation Week: Movie & Pizza Lunch	1
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Event	Youth Vacation Week: Movie And Pizza Lunch Tuesday February 19, 2013 : 11:00 AM - 01:00 PM Large Meeting Room

Please complete the following form and click on the Send button below.

To	Dan Barbour
	dbarbour@cwmars.org
Subject	EKRegistration Data

First Name *
Last Name *
Email*
Phone *
Bar Code
PIN	Create a password or enter existing one Why?

Grade	What grade are you in?

Thanks!

To submit this form, please click on the Send button just once...

This page last updated : 7.8.8.4 - 2013.04.13 7:00 AM
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