Southland CAPS Application
Please complete this form to apply for a Southland CAPS program. Please provide your school Gmail (Google) address as this is how you will be able to save or change your application.

Applications received prior to March 12, 2021 will take priority in the admissions process. We will continue to take applications until programs are full after the priority deadline.

Southland CAPS does not discriminate with regard to disability, national origin, race, religion, or gender.
Email *
Last Name *
First Name *
Street Address *
Please include the number and street. For example: 123 School Rd.
City *
Zip code *
Student Email
Parent/Guardian Name *
Parent Phone Number *
Parent Email Address *
Student Date of Birth *
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