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AAAC - PACE APPLICATION
Student Application
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* Indicates required question
Students ID Number (6 digits)
*
Your answer
Students First Name
*
Your answer
Students Last Name
*
Your answer
Students Date of Birth
*
MM
/
DD
/
YYYY
Students Current Age
*
Your answer
Reason for attending PACE
*
Credit Deficient (Behind on Credits)
Early Graduation
Medical Condition
Extenuating Circumstances
Intervention Counselor Referral
Drop out recovery
Other:
Student's Email Address
*
Your answer
Students Current Address
*
Your answer
Students Phone Number
*
Your answer
Have you met with your assigned Academic Counselor at AHS (Ms. Reeves, Mrs. Daley, Mrs. Coleman, or Ms. Johnson)?
*
Yes
No
Parents First Name
*
Your answer
Parents Last Name
*
Your answer
Parents Email Address
*
Your answer
Parents Phone Number
*
Your answer
Student Signature (Typed)
*
Your answer
Parent Signature (Typed)
*
Your answer
Date Signed
*
MM
/
DD
/
YYYY
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