Perry Innovation Center Student Application 17-18
As explorers of innovative educational practices, Perry Innovation Center provides an engaging, purposeful, student centered learning environment, to a student population that represents our community demographics.
Date
MM
/
DD
/
YYYY
Student First Name
Your answer
Student Last Name
Your answer
Student ID
i.e. 012345
Your answer
Address
including street address, city, state, and zip code
Your answer
Phone Number
include area code and dashes (i.e. 810-555-1212)
Your answer
Parent E-mail
Your answer
Student Date of Birth
Your answer
Parent/Guardians
Your answer
Current School
Grade Entering in Fall, 2017
Gender
Your answer
Does your child currently attend City School/Perry Innovation Center?
Please describe the reason(s) you are applying to attend the Perry Innovation Center:
Your answer
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