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.
Student's First Name *
Student's Last Name *
Student's Date of Birth *
MM
/
DD
/
YYYY
Student ID # (if currently at MMSD)
Student's Current Grade *
Student's Home Address - Street *
(Street)
Student's Home Address - City *
(City)
Student's Home Address - State *
(State)
Student's Home Address - Zip *
(Zip)
Student's Current School *
Your Name *
(First and last name of person filling out this form.)
Contact Information - Phone Number *
(Please use this format: (xxx) xxx-xxxx
Contact Information - Email *
(Please provide your email address.)
Your relation to the student? *
How did you hear about Shabazz? *
If you have questions about the application process please call 608-204-2440.
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