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Diversity Nurtures Achievements Community Youth Center
After School Program
&
Structured Learning Day Program
“Enrichment beyond the classroom”
CALL US: 910-293-7769
AFTER SCHOOL/SUMMER APPLICATION
First Name
Last Name
Gender
Male
Female
Date of Birth
Grade
Parent's/Guardian's Name
Permanent Address
Phone(Home,Work,Cell)
Emergency Contacts: Name, Address, Relation to Child, Telephone#
Submit
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