IIMF Middle School RegistrationSpring Essay Writing Workshop Thursday, March 27, 20255:00 PM - 6:30 PMDMACC Urban Campus, Building 71144 7th Street, Des Moines, IA 50314

Student Name

First Name

Last Name

Student Email Address (noname@noname.com)

Student Phone Number (xxx-xxx-xxxx)

Gender

School

Graduation Year

If you picked "other" for Middle school, please enter the name below.

Parent/Guardian Information

First Name	Last Name
Phone Number (xxx-xxx-xxxx)	Email (noname@noname.com)