Propel Andrew Street High School Pre-Registration Application
2014-15
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Student's First Name *
Please provide name and all other information as you would like it to appear on official letters, e-mails, and other forms of contact from Propel Schools.
Student's Middle Name
If none, leave blank.
Student's Last Name *
Please provide name and all other information as you would like it to appear on official letters, e-mails, and other forms of contact from Propel Schools.
Student's Birth Day *
Student's Birth Month *
Student's Birth Year *
Current Street Address *
Please provide in this format: 123 Main Street
Apartment/Unit/Floor number
(leave blank if not applicable)
City *
State *
Current Zip Code *
Grade entering AUGUST 2013 *
Student Gender *
Name of Parent or Guardian *
Ex: Joseph Smith.   Please provide first and last name in the format which you would like it to appear in official documents from Propel.
Preferred Phone number *
Important! Please provide phone number in this format only: xxx-xxx-xxxx
Secondary Phone Number (optional)
Important! Please provide phone number in this format only: xxx-xxx-xxxx
Parent/guardian E-mail Address *
Please provide your information as you would like it to appear on official forms of contact from Propel Schools.
Public School District of Residence *
Name of Current School *
Please check to make sure the school name is spelled correctly and completely. If the child(ren) have not attended a school previous to this upcoming year, please type "NA." If your child has been homeschooled previous to the 2014-15 school year, please enter "homeschool." Thank you.
Is your child a twin? *
Has your child ever attended a Propel school? *
Does the applicant have a sibling who currently attends a Propel School? *
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