NCSD Adult Ed Registration Form
Please take a moment to complete this form fully. If you have any questions, you may contact us at:
775-751-6822
Secretary - Mrs. Pam Fairchild: pfairchild@nye.k12.nv.us
Clerical Aide - Mrs. Mary Hayes: mhayes@nye.k12.nv.us
Counselor - Mr. Mike Abbiss: mabbiss@nye.k12.nv.us
Teacher - Mrs. Bonnie Chenevert: bchenevert@nye.k12.nv.us
Last Name *
Your answer
First Name *
Your answer
Middle Name *
Your answer
Maiden Name or Other Name Used in School - (This is important for when we request transcripts from other schools) *
Your answer
Gender (Mark the gender with which you most closely identify) *
Street Address/Physical Address *
Your answer
Apartment Number *
Your answer
City *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Birth Date *
MM
/
DD
/
YYYY
Birthplace (City, State) *
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of NYE COUNTY SCHOOL DISTRICT. Report Abuse - Terms of Service - Additional Terms