Corbin School of Innovation Application - Student Information
Please fill out the form below to apply.
Full Name (First, Middle and Last) *
Email Address *
Phone Number *
Mailing Address (Street Address - City - State - Postal/ Zip Code) *
Grade Level *
Age *
Gender
Date of Birth *
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DD
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Previous Schools Attended *
Do you have an IEP or 504 Plan? If Yes, and you are a Corbin Independent Student, please contact Jane Chandler, Special Education Director at the Corbin Board of Education at 606-528-3103 *
Required
Are you a part of the Corbin School District? *
If no, what school district are you a part of?
What Corbin School of Innovation Program are you interested in? *
How did you hear about us? *
Please upload 1 letter of recommendation, your essay on "Why you want to be in SOI", transcripts and attendance records. *
Required
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