Open Enrollment Application 2018-19
Open Enrollment is contingent upon availability of space and applications made between May 1 - August 1, 2018.
Student Last Name *
Your answer
Student First Name *
Your answer
Student Middle Name/Initial *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Grade Level for 2018-19 *
Parent/Guardian Name *
Your answer
Parent/Guardian Address (Street) *
Your answer
Parent/Guardian Address (City) *
Your answer
Parent/Guardian Address (State) *
Your answer
Parent/Guardian Address (Zip Code) *
Your answer
Parent/Guardian Email Address
Your answer
Parent/Guardian Mailing Address (if different from physical address) - Street
Your answer
Parent/Guardian Mailing Address (if different from physical address) - City
Your answer
Parent/Guardian Mailing Address (if different from physical address) - State
Your answer
Parent/Guardian Mailing Address (if different from physical address) - Zip Code
Your answer
Parent/Guardian Phone Number *
Your answer
School District of Residence *
Your answer
Registration Acknowledgement *
Required
District & School Attended in 2017-18: *
Your answer
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