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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:
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