Student Program Application
Student Information Please answer all questions truthfully. All information will be used solely for the purpose of providing our students with the best services possible. Student and Parent/Guardian must fill out and sign the form.
Address Line 2 - If Applicable
State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Ethnicity American Indian/Alaska Native Asian Black or African American Hispanic Multiracial Native Hawaiian or Other Pacific Islander White U.S Citizenship Status U.S Citizen Permanent Resident Other
Why Do we ask about citizenship? Do you receive (F.A.R.M) Free and Reduced Meals? Are you first generation college bound? Grade Level 9th 10th 11th 12th
Parent/Guardian Information Address Line 2 - If Applicable
State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Ethnicity American Indian/Alaska Native Asian Black or African American Hispanic Multiracial Native Hawaiian or Other Pacific Islander White Highest level of education Did not complete high school High School Graduate Some college Associate's Degree Bachelor's Degree Advanced Degree (Optional but recommended) U.S Citizenship Status U.S Citizen Permanent Resident Other Is your child in one of the following? IEP ESOL SPED None/Prefer not to say
Emergency Contact Information Address Line 2 - If Applicable
State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Ethnicity American Indian/Alaska Native Asian Black or African American Hispanic Multiracial Native Hawaiian or Other Pacific Islander White Highest level of education Did not complete high school High School Graduate Some college Associate's Degree Bachelor's Degree Advanced Degree (Optional but recommended) U.S Citizenship Status U.S Citizen Permanent Resident Other Submit
