Health Science Application Monroe High
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Student's Full Name *
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Primary email address communication should be sent to... *
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Date of Birth *
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Present Grade (during the 2019-2020 school year) *
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Are you attending a UCPS middle school? *
UCPS middle school attending
If you are not attending a UCPS school, please give us the name of the school you are attending.
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Student's address *
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Student's city *
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Student's email address (school if UCPS student) *
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Student's ID number (If not known enter N/A) *
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Father/ Guardian's name *
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Father best contact *
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Mother/Guardian's name *
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Mother's best contact *
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I understand that currently, there is no transportation to HSA unless I live in the Monroe High School attedance area. *
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