Urban Prep Charter Academy for Young Men:  Interest Form (Students entering 8th grade in Fall 2022)
Students that entering 8th-grade in Fall 2022, and interested in learning more about Urban Prep, please fill out the following form to receive additional application and enrollment information. We Believe.
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Enrollment Information
Campus of Interest (check all that apply) *
Required
Student Information
First Name *
Last Name *
Date of Birth *
MM
/
DD
/
YYYY
Current school you attend *
Current Grade Level *
Do you have a sibling/brother currently enrolled at Urban Prep? *
Required
If "Yes", please enter his name and select the campus he attends.
Parent or Guardian Information
For this section, please list ONE parent/guardian who should be the primary point of contact regarding this student’s application. Upon enrollment at Urban Prep, there will be an opportunity for you to add other parents/guardians to the students file.
Honorific *
First Name *
Last Name *
Relationship To Applicant *
Home Address *
Unit/Apt. #
City *
State *
Zip *
Cell/Mobile Phone Number *
(xxx-xxx-xxxx)
Home Phone Number
(xxx-xxx-xxxx)
Email Address *
How did you hear about Urban Prep (CHECK ALL THAT APPLY) *
Required
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