Shabazz City High School Application for Semester 2, 2020-21
NOTE: WE ARE NO LONGER TAKING APPLICATIONS FOR SEMESTER 2. THE WINDOW TO APPLY FOR THE 2021-22 SCHOOL YEAR WILL BE ANNOUNCED IN THE SPRING.
* Required
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Student's Date of Birth
*
MM
/
DD
/
YYYY
Student ID # (if currently at MMSD)
Your answer
Student's Current Grade
*
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Student's Home Address - Street
*
(Street)
Your answer
Student's Home Address - City
*
(City)
Your answer
Student's Home Address - State
*
(State)
Your answer
Student's Home Address - Zip
*
(Zip)
Your answer
Student's Current School
*
East High School
La Follette High School
Memorial High School
West High School
Badger Rock Middle
Blackhawk Middle
Cherokee Middle
Hamilton Middle
Jefferson Middle
O'Keefe Middle
Sennett Middle
Sherman Middle
Spring Harbor Middle
Toki Middle
Whitehorse Middle
Wright Middle
Other:
Your Name
*
(First and last name of person filling out this form.)
Your answer
Contact Information - Phone Number
*
(Please use this format: (xxx) xxx-xxxx
Your answer
Contact Information - Email
*
(Please provide your email address.)
Your answer
Your relation to the student?
*
Mother
Father
Guardian
Self
Other:
How did you hear about Shabazz?
*
School staff: counselor, psychologist, other
Website
Word of mouth
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Shabazz staff visited school
Other
If you have questions about the application process please call 608-204-2440.
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