Mott Middle College New Student Enrollment Application for 2024-2025 School Year
Please provide us with the following information below:
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Email *
Contact information: Please contact Diane Weeks at for more information regarding enrollment.
Today's Date: *
Student's LAST Name *
Student's FIRST Name *
Parent Name (First, Last) *
Address *
City *
State: *
Zip Code *
Primary Phone #: *
Secondary Phone #: *
Birth Date of Student: *
Current Age of Student: *
Last/Current School Attended: *
Last Grade Level Completed: *
School District Student Lives In: *
How did you find out about Mott Middle College?   *
Have you applied to Mott Middle College before? If so, When? *
Why are you interested in attending Mott Middle College? (must be completed by student) *
What is your Career Interest?   *
This form serves as permission to release student records to Mott Middle College deemed necessary by the enrollment team during the acceptance process. Do you agree to these terms? *
Please email the following documents to Diane Weeks, at 

behavior report, attendance report, 8th grade report card, or high school transcript.
These items are critical to your application status.
Any questions? Submit here
Thank you for applying to Mott Middle College High School for the 2024-25 School Year. We look forward to meeting you.
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