Collegiate Baton Rouge Application
STUDENT AND PARENT/GUARDIAN INFORMATION
Student First Name *
Your answer
Student Last Name *
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Current Address *
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City *
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State *
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Zip Code *
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Student's Date of Birth *
MM
/
DD
/
YYYY
Student's Gender
Student's Current Grade Level *
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Student's Current School *
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Parent/Guardian Full Name (first and last name) *
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Relationship to Student
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Do you have a legal right to enroll this child in school? *
Primary Contact Number *
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Secondary Contact Number
Your answer
Parent/Guardian Email Address *
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