ALPINE ACADEMY STUDENT ENROLLMENT FOR 2021-2022 SCHOOL YEAR
Email address *
Are you enrolling for the 2021-2022 school year? *
Student's Legal Name (Last/First, Middle) *
Student's preferred name/nickname
Sex *
Current Grade (2020-2021) *
Student's physical address *
Student lives with (If not with parents, documentation must be provided) *
Required
Student's Birthdate *
Student's Birth City *
Previous school name/ year *
Is student Latino/ Hispanic *
Ethnic Code (Check all that apply) *
Required
Check all that apply *
Required
Is your student under juvenile probation, suspended or expelled by current school? *
Primary guardian 1 (ex. mother) Full Legal Name *
Primary guardian 1 is *
Have parental rights been revoked? If yes, you must supply documentation *
Primary guardian 1's physical address (if different than student's)
Primary guardian 1's cell phone number *
Primary guardian 1's email address *
Check how you would like to receive notifications from Alpine Academy *
Required
Primary guardian 2's full legal name *
Primary guardian 2's is *
Have parental rights been revoked? If yes, you must supply documentation *
Primary guardian 2's physical address if different from student's
Primary guardian 2's cell phone number *
Primary guardian 2's Email *
Check how you would like to receive notifications from Alpine Academy *
Required
Stepparent living with student
Stepparent's phone number
Local Emergency Contact #1 include name, relationship to student, and cell phone # *
Local Emergency Contact #2 include name, relationship to student, and cell phone # *
Electives for the next year (please pick your top three choices)
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Alpine Academy. Report Abuse