QSHSO INTAKE APPLICATION
Please fill out each section of the application.
Email address *
Date of Application
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APPLICANT'S FIRST AND LAST NAME *
Date of Birth *
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Applicant's OSIS # *
Home Address *
City/Borough *
State and Zip Code *
Student's Cell Phone
Student's Email
NAME OF CURRENT SCHOOL *
Name of guidance counselor and contact information
Current Grade
Clear selection
How many credits do you have? *
Do you have an IEP?
Clear selection
Are you an ENL Student?
Clear selection
Have you ever been suspended?
Clear selection
How did you hear about QSHSO? Please check all the boxes that apply
Do you have any friends and/or relatives that are currently attending or have attended QSHSO?
Clear selection
If you answered yes, please write the person's name below
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This form was created inside of Queens Satellite High School for Opportunity.