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Online Application Submission
Prospective student's first name *
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Prospective student's last name *
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Date of Birth *
MM
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DD
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YYYY
City & State of Birth: *
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Gender *
What is your primary language? *
Your answer
Is your student Hispanic? *
Ethnicity *
(Check all that apply.)
Required
Address *
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City *
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State *
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Zip *
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What county do you live in? *
Primary Phone *
Example: 555-555-5555
Your answer
Is the above Phone number your: *
E-Mail address
Your answer
Preferred Method of Contact *
I am applying to enroll: *
Where is your student currently attending school? *
Your answer
What school district do you live in? *
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What is your student's current grade level? *
What is your student's grade level for next year? *
Does your student have an IEP/ETR? *
Does your student have a current 504 learning plan? *
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