Left banner Left banner

Online Student Application


Student Information
Student's Name:
Date of Birth:
Street Address:
City - State - Zip Code:
School District Residence:
Current School Attending:
School Address and Zip Code:
Referred By:
Applicant's Gender:
Applicant's Race:
Special education or related services (IEP/504):
Safe Schools Violation:
Contact Information
Name of Parent or Guardian:
Primary Phone #:
Alternate Phone #:
E-mail address:
Preferred Appointment/Tour Day:
Preferred Appointment/Tour Time:
Security Code:
Enter the code shown above in the box below
* required