Spring ACP Pre-Registration
Please complete even if you are only considering taking an IU Dual Credit (ACP) course for IU credit next year
This form must be completed by Friday May 19th. Please see Mrs. Clark in counseling with questions.
First Name *
Your answer
Middle Name *
Your answer
Last Name *
Your answer
Sex *
Birth Date (PLEASE USE THIS FORMAT mm/dd/yyyy) *
Your answer
Please Check 1 *
Required
RACE/ETHNICITY
Please only respond to one of the following questions regarding race/ethnicity. Check witch option applies to you
Please check here if your race/ethnicity is WHITE
Please check here if your race/ethnicity is AFRICAN AMERICAN
Please check here if your race/ethnicity is HISPANIC
Please check here if your race/ethnicity is ASIAN AMERICAN
Please check here if your race/ethnicity is NATIVE AMERICAN
Please check here if your race/ethnicity is HAWAIIAN
Email (PLEASE MAKE SURE THIS IS CORRECT and NOT a school email address) *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
County (Enter Lawrence or other county)
Your answer
Grade NEXT year (2018-19 School year) *
Free/Reduced Lunch *
Contact Number (w/Area Code)
Your answer
Full School Name *
Submit
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