GLOBAL ENTREPRENEUR LEARNING INSTITUTE WEB BIZ BOOTCAMP REGISTRATION
	First and Last Name:
	Email Address:
	Parent or Legal Guardian's Name
	Phone Number
	City
	State
	Zip Code
	High School Attending
	Please indicate your status	Senior Junior Sophmore Freshman
	Have you ever registered a domain name?	Yes No
	If yes, what is the domain name address?
	Do you or your family own a business?	Yes No
	Name of Business?
	Website Address?
	Do you use social networking sites?	Myspace Facebook Other