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Lopez High School Application for 2023-2024
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* Indicates required question
Email
*
Your email
Student Name/Nombre del estudiante
*
Your answer
LMUSD Student ID #
Your answer
Current School/Nombre actual de la escuela
*
Your answer
Current Grade/Grado Actual
*
Choose
10th
11th
12th
Is the student applying for/Estamos aplicando para el programa alternativo:
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Lopez High School/Secundaria Lopez
Lopez High School Independent Study/Estudio Independiente
HOPE (Hands On Parenting Education Services) Requested
Required
Date of birth/Fecha de Nacimiento
*
Your answer
Age/Edad
*
Your answer
Parent/Guardian Name/Nombre del Padre/Tutor
*
Your answer
Parent/Guardian phone number/Numero celular del Padre/Tutor
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Your answer
Student cell number/Numero celular del Estudiante
*
Your answer
Student Mailing Address/Domicillo postal del estudiante
*
Your answer
Student Residence Address/Domicilio de residencia del estudiante
*
Your answer
Language Spoken at Home/Idioma que se habla en casa
*
Your answer
Student lives with/El estudiante vive con
*
Parents
Grandparents
Other
Required
If you answered "Other" to the previous question: "Student lives with- please explain here. Explique con quien vive el estudiante.
Your answer
Phone number of the person student lives with/Número de teléfono de la persona con la que vive el estudiante
*
Your answer
Does Student have an IEP or 504?/¿El estudiante tiene un IEP o 504?
*
IEP
504
No IEP or 504
Does the student have an active or previous SST?/¿Tiene el estudiante un SST activo o previo?
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Yes
No
Maybe
Has the student be expelled previously?/¿El estudiante ha sido expulsado previamente?
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Yes
No
Does the student have a behavior contract?/¿Tiene el estudiante un contrato de conducta?
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Yes
No
Is the student on probation or diversion?/¿Está el estudiante en libertad condicional o diversión?
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Yes
No
Name of probation officer/Nombre del Oficial de Probatoria
Your answer
Probation officer phone number/Número de teléfono del Oficial Probatoria
Your answer
Has the student been through the SARB process previously?/¿El estudiante ha pasado por el proceso SARB anteriormente?
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Yes
No
Unsure
PARENTS/GUARDIANS: Please provide a written statement explaining why you are requesting Lopez High School./PADRES O TUTORES: Favor de escribir un comentario indicando por qué está solicitando Colocación en Educación Alternativa.
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Your answer
STUDENTS: Please provide a written statement explaining why you are requesting Lopez High School./ ESTUDIANTES: Favor de escribir un comentario indicando por qué está solicitando Colocación en Educación Alternativa.
*
Your answer
Who is your current high school counselor?/¿Quién es su consejero actual de la escuela secundaria?
*
Your answer
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