THIS ENROLLMENT AGREEMENT IS REQUIRED BY THE STATE OF CALIFORNIACisl Adult Programs Enrollment Agreement • November 23rd, 2021
Name Mr. Ms. Last First Middle Address (Permanent) Apt/House Street City State or Province Zip code Country Email Address Telephone Country of Citizenship Date of Birth(e.g. January 20, 1982) Month: Day: Year: City of Birth Country of Birth
