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Urban Prep Charter Academy for Young Men: Transfer Information Form
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Email *
Campus(es) of Interest *
Required
Student Information
First Name *
Last Name *
Date of Birth *
MM
/
DD
/
YYYY
Current Grade Level *
Current School *
Do you have a sibling/brother currently enrolled at Urban Prep? *
Required
If so, what is his name?
Select the campus he attends.
Do you have an older brother who graduated from Urban Prep? *
If so, what’s his name and what Campus did he attend?
Parent or Guardian Information
For this section, please list ONE parent/guardian who should be the primary point of contact regarding this student’s application. Upon enrollment at Urban Prep, there will be an opportunity for you to add other parents/guardians to the students file.
Honorific *
First Name *
Last Name *
Relationship To Applicant *
Parent or Guardian's Email Address *
Home Address *
Unit/Apt. #
City *
State *
Zip *
Cell/Mobile Phone Number *
(xxx-xxx-xxxx)
Home Phone Number
(xxx-xxx-xxxx)
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