Registration Form
Please fill out the information below to be contacted for enrollment at CUNY Prep.
The next enrollment period will be JANUARY 2019 (FALL).

Please Note, the following documents are required for 16-18y/o
Birth Certificate
Social Security Card
Immunization Record
Proof of current address
High School Transcript.

Today's Date *
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Full Name (Last, First) *
Your answer
Age *
Your answer
Date of Birth *
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Telephone Number *
Your answer
Email Address (if available)
Your answer
If you are 16-18 years old, please select one of the following reasons for attending *
Have you passed any New York State Regents Exam(s)? *
Please Check off ALL passed REGENTS below
I am 19 years old or older, applying for night school *
Counselor Referral? Add Name & Contact Info Below.
Your answer
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