High School Hillyard Technical Center Registration 2018-2019
Student's Legal First Name *
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Student's Legal Last Name *
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Grade:
Birthdate *
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DD
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Gender *
High School: *
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Student Cell Phone Number:
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Student Email Address
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Hillyard Program: *
Daytime Telephone Number (used to verify attendance) *
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Parent/Guardian Email (used to verify attendance). Enter N/A if you do not have an e-mail address. *
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Home Street Address: *
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City *
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State *
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Zip Code *
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Is your mailing address the same as your home address? *
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