Name *

First Name

Last Name

Spouse's Name

First Name

Last Name

Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Residence Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone *

(###)

###

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Home Phone

(###)

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Your Birthday *

MM

DD

YYYY

Spouse's Birthday

MM

DD

YYYY

I have read and agree with the Statement of Faith. *

(Please fill in your name as your electronic signature)

I Agree

What will you be doing this summer? *

Returning Home

Staying in Murrieta

Will your housing for the next school year stay the same? *

Yes

No (If no, a description is required below)

By checking this box, I hereby state that all the information contained in this application is correct and true. *

Yes

Electronic Signature *

(Please fill in your name as electronic signature)

First Name

Last Name