Independence High School 2021-2022
Hello to our future students and parents/guardians,

Thank you for your interest in Independence High School! We are beginning to enroll students for Fall 2021!

We will be hosting orientation sessions and we encourage you to join one of our sessions to find out more about our school community, instruction, and programs that are offered. If you have any questions, please email us at and we will be happy to assist you!

Please send transcript/permanent record, immunization record, and Individualized Education Plan (if applicable) to after completing this form. If you do not have all documents, please send us an email and we can assist.

Denise Yepez and Emily Cabrera
Email *
Student's Name *
Student's Osis Number
Student's Birthday *
Student's Cell Phone Number *
Student's Email *
Address *
Who does the student reside with? *
Parent/Guardian Name #1 *
Parent/Guardian #1 Contact Number *
Parent/Guardian #1 Email *
Parent/Guardian #1 Primary Language *
Parent/Guardian #2 Name
Parent/Guardian #2 Phone
Parent/Guardian #2 Email
Additional Emergency Contact Person *
Emergency Contact Person's Phone Number *
Current or Last Attended School (if not a NYC DOE school, please include city and state) *
Does the student have an Individualized Education Plan (IEP)? We have a Special Education Team that will reach out! *
Does the student receive English Language Learner Services (ELL)? *Information gathered for planning purposes only. *
How many credits does the student have? *
Which Regents Exams has the student passed? Please select all that apply *
Which orientation session are you interested in attending? *
A copy of your responses will be emailed to the address you provided.
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