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Request A Student Center

Required fields are denoted with an asterisk.

	I am a WUSD teacher who would like to set up one or more Student Centers.
	I am an educator and would like to set up one or more Student Centers.
	I am an administrator and would like to set up multiple Student Centers on behalf of teachers at my school/institution.

*First Name:
*Last Name:
*E-mail:
School/Institution:
State:	-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming
*Daytime Phone:
*School:	-- Alternative Learning Center Douglas Elementary Lebanon Elementary Lincoln Elementary Riverside Middle School Schurz Elementary Watertown High School Webster Elementary
School/Institution Web Site:
Number of classes  or student groups:
	My students have their own district e-mail accounts with which they can receive communications from the Student Center.
	My students do not have their own district e-mail accounts and will need to use the Student Center's internal communication system.
	I have read, understand, and agree to the Terms of Agreement.*

*First Name:
*Last Name:
*E-mail:
School/Institution:
State:	-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming
*Daytime Phone:
School/Institution Web Site:
	I would like to have district/institution-branded Student Centers ?
	Students have their own district e-mail accounts with which they can receive communications from the Student Center.
	Students do not have their own district e-mail accounts and will need to use the Student Center's internal communication system.
	When signing teachers up, be aware that the teachers will receive an email with a link to their respective Student Centers. Please be sure to inform teachers accordingly.
	add another teacher
	I have read, understand, and agree to the Terms of Agreement.*

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