STUDENT REGISTRATION FORM

Reg. Code: COLGA001
     
    Welcome to Lynnette Shields's class!
     
    First Name:Middle Name (optional):Last Name:
     
    Ethnicity (Optional):Age:GenderE-mail Address:
    Choose User Name:
    (Max 8 Characters)    		Choose Password:
    (Max 8 Characters)
    Retype Password:
     
    Please select a secret question:Answer:
    Has anyone taught you how to manage your money?   yes no
    Why did you decide to explore Banking on Our Future?  
    Have you had a Banking on Our Future volunteer in your classroom?   yes no
    If 'yes' how many times?