Student Information 2017-2018
STUDENT DEMOGRAPHIC INFORMATION
Student First Name
Your answer
Student Last Name
Your answer
Career Technical Program
Gender
Required
Birthdate
MM
/
DD
/
YYYY
Associate School District
PARENT/GUARDIAN 1
Parent/Guardian
Parent Guardian Prefix
Parent/Guardian First Name
Your answer
Parent/Guardian Middle Initial
Your answer
Parent/Guardian Last Name
Your answer
Parent/Guardian Suffix (Jr., Sr., III)
Your answer
Parent/Guardian Mailing Address
Your answer
Parent/Guardian Residential Address
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Parent/Guardian City
Your answer
Parent/Guardian State
Your answer
Parent/Guardian Zip Code
Your answer
Parent/Guardian County
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Parent/Guardian Voice Phone Number
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Parent/Guardians Text Phone Number
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Parent/Guardian Employer
Your answer
Parent/Guardian Work Phone
Your answer
Parent/Guardian E-mail
Your answer
Parent/Guardian Contact Type (Please check all that apply)
Required
Is there another Parent or Guardian?
If parents do not live together should correspondence be sent to non-residential parent?
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