Summer Credit Recovery Application
Please fill out and submit this form to apply to the 2018 Summer Credit Recovery program.
Student's Last Name *
Your answer
Student's First Name *
Your answer
Student's phone #
Your answer
Student's email
Your answer
Parent/Guardian's phone # *
Your answer
Parent/Guardian's email
Your answer
Mailing address *
Your answer
City *
Your answer
Zip Code *
Your answer
High School *
Your answer
Grade *
Your answer
Graduation Year *
Your answer
Date of Birth (format: 01-01-2000) *
MM
/
DD
/
YYYY
Gender *
Current GPA
Your answer
Courses you intend to recover (check all that apply) *
Required
Four locations are being offered. Which location(s) do you prefer? (Check all that apply; additional locations to be decided.) *
Required
Are you available Monday-Friday from 9AM-2PM between June 25, 2018 and August 3, 2018? *
If No, please list specific reasons:
Your answer
How did you hear about the Summer Credit Recovery Program?
Your answer
Submit
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