2024-25 Registration

Please fill out one per student!

Name(Required)

First Middle Last

School Student is Transferring From(Required)

Previous School Name and Address

Student Date of Birth(Required)

Student Social Security Number (last 4)(Required)

Grade(Required)

Student Scholarship

Student Scholarship Number

Student Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Student Home Phone

Student Cellphone

Parent #1 Name(Required)

First Last

Parent #1 Work Phone(Required)

Parent #1 Cellphone Phone(Required)

Last 4 of Parent #1 SSN(Required)

Parent #1 Email(Required)

Parent #2 Name

First Last

Last 4 of Parent #2 SSN

Parent #2 Email

Parent #2 Cellphone Phone

Parent #2 Work Phone

Emergency Contact(Required)

First Last

Relationship To Student(Required)

Cell Phone #(Required)

Work Phone #

Please list ALL allergies if any that your child may have:

Please list ALL medications student is currently taking:

2024-2025 Registration Fee(Required)

Price:

Credit Card(Required)

Card Details

Cardholder Name