Pre-Register for BENERGY Enrichment Education

Yes! I want to get BENERGIZED.

Simply submit this form and we will add you to our registration list for BENERGY Enrichment Education.

We expect the program to be available Fall 2025. We’ll keep you updated so you know when you can get started.

Name (optional) Student

Parent's Name

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Last

Parent's Email

Address

Address Line 1

Address Line 2

City

State

Zip Code

Student #1 Name

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Last

Student #1 Age

Student #2 Name (optional)

First

Last

Student #2 Age

Student #3 Name (optional)

First

Last

Student #3 Age