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Student Application to Alpha
Brewer High School Alternative Education Program

All applications are electronically submitted to Alpha staff.

Email address *
First Name *
Your answer
Last Name *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Student's Current Year in H.S. *
Name of Guidance Counselor- *
Parent(s)/Guardian(s) Name *
Your answer
Student's earned credits to date *
Your answer
Why are you applying to Alpha? *
Your answer
What is your educational goal? *
Your answer
What are your future plans? *
Your answer
Do your parent(s)/guardian(s) know you are applying to Alpha? *
What was your best year in school and why? *
Your answer
Check all that apply to you *
Required
Have you ever received Special Education Services? *
Have you ever refused Special Education Services? *
Are there any medical concerns we should be aware of? *
Your answer
Name 2 Individuals (Teacher, Counselor, Relative) who you can get a recommendation from. *
Your answer
A copy of your responses will be emailed to the address you provided.
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