NEW Student Application

Student Application

Parent Connection Instructions:

For the "Parent" field below, please find your (the parent's) last name, first initial and last 4 of your phone number from the drop down list. This is going to connect your record to your student's record.

HINT: Start typing your last name.

Parent

Student Information

First name

Last name

Gender

Birth Date

Grade Level

Funding Type

Parent Email Address

Parent Cell Phone

Does your student have any learning disabilities/IEP/504?

Yes No Not Selected

If yes, please list

Does your student have any allergies/medical conditions?

Yes No Not Selected

If yes, please list

Does your student have behavioral issues or previous expulsion or suspension?

Yes No Not Selected

If yes, please list

By submitting this form, you hereby confirm that every question was entered completely and honestly.