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 February 16, 2020 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 address *
Last Name *
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First Name *
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Street Address *
Please include the number and street. For example: 123 School Rd.
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City *
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Zip code *
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Student Email
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Parent/Guardian Name *
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Parent Phone Number *
Your answer
Parent Email Address *
Your answer
Student Date of Birth *
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