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AVID Application: Central Middle School
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* Indicates required question
Email
*
Your email
Parent's name (first and last)
Your answer
Parent contact #.
Your answer
Student Last Name
*
Your answer
Student First Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Current Grade Level
*
6
7
8
What school are you currently attending?
*
Your answer
Are you zoned for Central Middle School?
*
Yes
No
Student's Race
*
Choose
Asian or Pacific Islander
Black, Non-Hispanic
Hispanic
American Indian or Alaskan
Multiracial
Hawaiian Native/Pacific Island
White, Non-Hispanic
Student's Ethnicity
*
Choose
Hispanic/Latino
White (to include Middle Eastern)
Black/African American/Haitian
Asian
American Indian/Alaskan Native
Native Hawaiian/Other Pacific Islander
Are you entitled to free or reduced lunch?
*
Yes
No
What language is spoken most at home?
*
Your answer
Special Circumstances: Does the student meet any of the following (check all that apply)
*
Foster Care
Homeless/In-Transition
Single-parent household
Orphan
No special circumstances
Other:
Required
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