2021-2022 Student Application
Please answer each question completely.
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Email *
Student's Name: *
Student's Date of Birth *
MM
/
DD
/
YYYY
Application for Grade: *
Required
Student's Primary Address: *
City/State/Zip: *
Primary Telephone: *
Secondary Telephone: *
Race *
Required
If child has a sibling, please provide siblings name(s), age and current school. *
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