Summer Credit Recovery Application
Please fill out and submit this form to apply to the 2017 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)
Required
Are you available Monday-Friday from 9AM-2PM between June 26, 2017 and August 4, 2017?
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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