Loading...

Editing previous response:

Please fix the highlighted areas below before submitting.

High School Student Registration Form- Summer 2024

Student Information

How did you hear about us?*
Answer Required
We would like to stay in communication. Do you accept to receive text messages from us (xxx-xxx-9001)? (Data rates may apply. This number only delivers messages.)*
Answer Required
Address
Gender*
Answer Required
Race*
Answer Required

Employment

Labor Force Status*
Answer Required
Are you receiving Government Assistance/CalWorks (Medi-Cal/Medicare, CalFresh, EBT, WIC, any government assistance)?*
Answer Required

Education

Highest Education Level*
Answer Required
Highest Grade Level Completed*
Answer Required
Have you ever received special education services?*
Answer Required
Do you have an active IEP (Individualized Education Program)/accomodations?*
Answer Required
If under 18 years old, have you been released from your current high school?*
You are a current student of Nogales HS, Rowland HS, Santana HS.
Answer Required
Majority of my schooling was outside of the U.S.*
Answer Required

Goals

Primary Goal*
Answer Required
Secondary Goal*
Answer Required

Emergency Contact

Program interested in:*
Answer Required
Students must attend orientation before they can begin class. Orientations are scheduled weekly on Wednesdays. Please select your preferred orientation appointment time:*
Answer Required
Have you attended our school before?*
Answer Required

Once you submit this form, you will receive a confirmation email immediately. If you do not receive a confirmation email upon submittting the form, please try again. 

Confirmation Email