Jasper Application 2021-2022: Part 1
* Required
Student Name
*
Your answer
What is your East Penn student email account?
*
Your answer
Parent/Guardian Name
*
Your answer
Address
*
Your answer
Parent/Guardian Email
*
Your answer
Parent/Guardian Cell Phone or Home Number
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Present Middle School
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Lower Macungie Middle School
Eyer Middle School
Other:
Do you have an IEP or 504?
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Yes, I have an IEP
Yes, I have a 504
No
Required
What math course are you enrolled in now?
*
Math Course 3
Algebra 1 Honors
Algebra 2 Honors
Geometry Honors
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