New Student Registration 2019-2020
* Required
Student Last Name
*
Your answer
Student First Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Class Applied for
*
Choose
k3
k4
k5
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Social Security Number
*
Your answer
Gender
*
Male
Female
Home Address
*
Your answer
Home Phone Number
Your answer
Parent/Guardian Name
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Parent Work Number
Your answer
Parent Email Address
*
Your answer
Parent/Guardian ( 2) Name
Your answer
Parent/Guardian (2) Email Address
Your answer
Parent/Guardian(2) Phone Number
Your answer
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