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 *
mm/dd/yyyy
Your answer
State ID Number
Please enter the student's state ID #
Your answer
Parent/Guardian Name *
Your answer
Home Mailing Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone *
Your answer
Cell Phone
Your answer
Gender *
Required
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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