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Full Time
Application Form

This form should be submitted during the application period, February 1 to April 30, to be considered for enrollment for the next school year.  Notification of application status will be received via email on May 15 of each year.


STUDENT DEMOGRAPHICS
First Name
 Middle Initial
 Last Name
 Date of Birth mm/dd/yyyy
 Gender
Male Female
Address
 City
 State
 Zip
Email Address
 Home Phone
 Cell Phone
 Graduating Class Of
RESIDENT DISTRICT
Name of School District (resident)
 Contact Person
 Phone
Address
 City
 State
 Zip
COURSE REQUEST INFORMATION
I request the following course(s) to be taken during the upcoming school year:
Course #1 Course #7
Course #2 Course #8
Course #3 Course #9
Course #4 Course #10
Course #5 Course #11
Course #6 Course #12
APPROVAL
Student Signature
 Date mm/dd/yyyy
 Parent Signature
 Date
mm/dd/yyyy
by checking this box you have created an electronic signature as legally binding as your handwritten signature  



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