Student Pre-Application Form
Student's Legal Name
First: *
Please enter students first name.
Last: *
Please enter students last name.
Middle:
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Preferred:
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Student's Address
Address: *
Please enter students street address.
City: *
Please enter students city of residence.
State: *
Please enter students state of residence.
Zip: *
Please enter students zip code.
Birth Information
Date of Birth: *
Please enter student\'s date of birth.
Birthplace (country):
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Ethnic Background: *
Please select students ethnic background.
Education Information
Current School:
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Current Grade:
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School year you are applying for: *
Please select a school year.
Grade That Year:
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What would your neighborhood school/district be based on your address?
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Names of Siblings Enrolled (if any):
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Please describe any additional support that your child has been given:
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Parent/Guardian Contact Information
Student is living with: *
Please select person student is living with.
If other, please designate:
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Mother/Guardian's Name:
Please enter parent/guardian\'s name.
Address (if different):
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City:
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State:
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Zip:
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Home Phone:
Please enter a phone number.
Work Phone:
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Cell Phone:
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E-mail: *
Please enter a valid email address.
Father/Guardian's Name:
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Address (if different):
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City:
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State:
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Zip:
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Home Phone:
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Work Phone:
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Cell Phone:
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E-mail:
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