2025-2026 Adult High School Registration Form
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Student's First Name/Nombre del estudiante *
Student's Last Name/Apellido del estudiante *
Lakewood School District ID Number (If Applicable)/Número de identificación del distrito escolar de Lakewood (si corresponde):
Student's Date of Birth/Fecha de nacimiento del estudiante *
MM
/
DD
/
YYYY
Student's Gender/Género del estudiante *
Student's Place of Birth/Lugar de nacimiento del estudiante *
Student's Email Address/Dirección de correo electrónico del estudiante *
Student's Drivers License Number (if applicable)/Número de licencia de conducir del estudiante (si corresponde)
Choose One/Elige uno *
Did the student attend Lakewood High School? *
If you did not attend Lakewood High School, what school did you attend?/Si no asistió a la escuela secundaria Lakewood, ¿a qué escuela asistió?
Were you born in the United States?/¿Naciste en los Estados Unidos?/ *
Did you have an IEP when you attended school?/¿Tuviste un IEP mientras estabas en la escuela?/ *
List two (2) Emergency Contacts - Name, address and phone number./Enumere dos (2) contactos de emergencia: nombre, dirección y número de teléfono./ *
Race/Ethnicity/Raza/Etnia: *
Home Language for phone calls and letters/Idioma del hogar para llamadas telefónicas y cartas: *
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