Email address *
2019-2020 Application Form for Ann Arbor Learning Community
Student Information
Legal last name *
Your answer
Legal first name *
Your answer
2019-2020 Grade Level
Gender *
Birthdate (month / date / year) *
MM
/
DD
/
YYYY
What language(s) does the student speak? *
Your answer
Has your student been expelled or suspended from another school? *
Does your student receive special education services listed on an IEP? *
Parent / Guardian Information
Name(s) *
Your answer
Adult's relationship to student *
Street Address *
Your answer
City *
Your answer
Zip code *
Your answer
Does your student live at this address? *
Primary phone (xxx - xxx - xxxx) *
Your answer
Additional phone (xxx - xxx - xxxx)
Your answer
Email address(es)
Your answer
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