WAVE Referral Form
Please fill out the following form with your student's information and someone from the WAVE office will contact you within a week. Thank you!
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Email *
FIRST NAME *
MIDDLE NAME *
LAST NAME *
DATE OF BIRTH *
STREET *
CITY *
PARENT/LEGAL GUARDIAN *
PHONE NUMBER *
EMAIL ADDRESS *
Are you interested in WAVE High School or WAVE Middle School?  *
STUDENT IS 18
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LAST SCHOOL ATTENDED *
ADDITIONAL SCHOOL(S) ATTENDED
HOW MANY CREDITS DOES STUDENT HAVE?
DOES THE STUDENT HAVE AN IEP? *
DOES THE STUDENT HAVE A 504? *
Please give a brief description of why you would like to meet:
WAVE has OPEN ENROLLMENT every Tuesday and Thursday from 10am -2pm. NO APPOINTMENT NECESSARY. Feel free to come in during our open times to fill out paperwork and take a tour. Please bring with you your student's birth certificate, immunization records, and two pieces of mail with parent or legal guardian's name and address showing. 
Do you have any questions?
How did you hear about WAVE?
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Today's Date
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This form was created inside of Washtenaw Alliance for Virtual Education.

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