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SPEED REGISTRATION FORM
2021-22 School Year
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* Required
Email
*
Your email
Program:
*
Academy for Lifelong Learning
Early Learning Center
Independence Elementary School
Program for Adaptive Learning
Note: This information will accompany the student in an emergency/crisis.
*
New Student
Returning Student
Required
Student's FIRST Name:
*
Your answer
Student's LAST Name
*
Your answer
Date of Birth:
*
MM
/
DD
/
YYYY
Sex:
*
Male
Female
Home District:
*
Your answer
Student Current Address, City, Zip Code
*
Your answer
Current Phone Number
*
Your answer
We offer text messages as a form of communicating with parents/guardians. A text will be sent to your cell phone where you can opt-in or opt-out of receiving them.
*
Yes, Text me
No, Do Not Text me
Please enter your cell phone number(s) if you would like to receive these texts.
Your answer
How would you like to be notified with important news, such as school closings and announcements? Please check below:
*
via phone call
via email
Required
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