2018 - 2019 Satellite Student Information Request
Your student is participating in a Polaris Career Center Satellite Program. These classes are taught by Polaris staff members at your student's school. To help us prepare for them, we are asking that you fill out this survey.

Please fill out this questionnaire for the student named on the envelope mailed to your house. If you have multiple students, please complete one request form for each student. This survey has between 2 and 3 pages. Please make sure to press the "next" button or "submit" button on the bottom of each page until you get a message that your survey is complete.

What is your home district? *
Student's First Name *
Your answer
Student's Last name *
Your answer
Primary Home Street Address during the school year *
Your answer
City *
Your answer
Zip *
Your answer
Primary Parent/Guardian Phone Number *
Your answer
Parent/Guardian Email Address *
Your answer
Student's Email Address
Your answer
Student's T-shirt size *
Shirt sizes are all ADULT sizes
What grade will your student be in for the 2018-2019 school year? *
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