Summer School 2017
This registration form is only for students and schools outside Minot Public Schools. Please see your school counselor to register.

Students in Minot Public School will register with their counselors in Power School.

If you would like to print a copy of this form for your reference, please be sure to print the page before submitting. Questions can be directed to Mr. Cox at 857-4645.

Student First Name
Your answer
Student Last Name
Your answer
Birth Date
Your answer
State ID Number
Please enter the student's state ID #
Your answer
Parent/Guardian Name
Your answer
Home Mailing Address
Your answer
Your answer
Your answer
Zip Code
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Grade Level (from the 2016-2017 school year)
Please enter your current school name
Your answer
Are any parents "Active" Military
Currently Assigned Special Services
AM Session (June 5-23, 8am - 12pm)
PM Session (June 5-23, 12:30 - 4:30pm)
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