Student Registration Form 2022-2023

Required

Student Namerequired

First Name

Middle

Last Name

Date of Birthrequired

Sex

Male

Female

Email Addressrequired

Sending Schoolrequired

Student Cell Phone

Legal Residence (Town to which you pay property taxes)required

Parent/Guardian 1 required

First Name

Last Name

Home Addressrequired

City/Staterequired

Zip Code required

Home Phone required

Cell Phone

Work Phone

Primary Email Addressrequired

Parent/Guardian 2 Namerequired

First Name

Last Name

Home Address

Same As Parent/Guardian 1 required

YES

City/State

Zip Code

Home Phone

Work Phone

Cell Phone

Primary Email Addressrequired

Course Requests

Please select 1 English course

English 9

Honors English 9

Please select 1 Math course

Math Foundations

Algebra 1

Honors Algebra 1

For information regarding course choices please click