Barton Online Forms

Barton County Upward Bound Information

Name:	Date:
Gender: Male Female

Home Address:
City, State, Zip:

Home Phone:	Cell Phone:
Email Address:

School currently attending:

Claflin Ellinwood Great Bend Hoisington

Current Grade Level: 8th Grade Freshman Sophomore

Name of Parent/ Guardian:
Phone number at which Parent/ Guardian can be reached:

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