Student Registration
Student Name (Last, First, Middle) *
Your answer
Birth Date *
MM
/
DD
/
YYYY
Previous School *
Your answer
Home Address (Street, City, Zip Code) *
Your answer
Does this student require busing services? *
Guardian 1 Name (Last, First, Middle) *
Your answer
Guardian 1 Address (if different from Student Home Address)
Your answer
Guardian 1 Cell Phone *
Your answer
Guardian 1 Work Phone *
Your answer
Guardian 1 Home Phone *
Your answer
Guardian 1 Email Address *
Your answer
Guardian 2 Address (if different)
Your answer
Guardian 2 Cell Phone
Your answer
Guardian 2 Work Phone
Your answer
Guardian 2 Home Phone
Your answer
Guardian 2 Email Address
Your answer
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