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First name*

Last name*

Phone*

Email*

Method of Payment*

Location of Interest*

Age of Child/Children*

School they Attend (if school aged)

Hours Needed for Care*

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Day

Year

Time

:HoursMinutes

Locations

1916 W Spencer Avenue

Philadelphia, PA 19141

215.309.3133

btblearningacademy@yahoo.com

2443 Ridge Avenue

Philadelphia, PA 19121

215.309.3133

info@btblearningacademy.org

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