Learn Stage - Signup Page - Excel High School Gale Partnership

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If you do not have an account, please enter all the required fields below. Please enter your correct e-mail address. You need to activate your account before you can login and activation code will be sent to your e-mail address.

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Sign-up:

E-Mail
Password	(at least 8 characters)
First Name
Middle Name	(If not applicable, leave blank) If applicable, write it in full. Correct format is "Daniel" not "D.".
Last Name
Suffix
Birth Date	- -
Gender
Ethnicity
Address	(If applicable, include Apt#) Write your full address and if applicable, include your Apt# or Suite# at end of the address. (i.e. "1234 A. Street Apt# 56")
City
State
Zip
Country	If your Country is not listed, select OTHER COUNTRIES and write the country name separated by Comma [,] in the ZIP field above. i.e. Zip: 12345, Country
Primary Phone
Secondary Phone
Enrollment Agreement:	I have read and agreed to the Excel High School enrollment agreement.
Signed:	Printing your full name in this box constitutes an electronic signature. You agree that all information submitted here is true and correct to the best of your knowledge.