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MPHS Registration Request
Please complete this form separately for each student you wish to enroll at Middle Park High School
Student's First Name *
Your answer
Student's Middle Name *
Your answer
Student's Last Name *
Your answer
Student's Date of Birth *
MM
/
DD
/
YYYY
Mailing Address *
Your answer
Physical Address *
Your answer
Student's Gender *
Required
Student's Incoming Grade Level *
Your answer
Planned enrollment date *
MM
/
DD
/
YYYY
Has the student ever been enrolled in an EGSD school at any time in the past? *
If yes, which school did they last attend?
Parent name *
Your answer
Parent phone # *
Your answer
Parent email address *
Your answer
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