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High School Student Registration Form- FALL 2023

Student Information

How did you hear about us?*
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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.)*
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Address
State*
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What is your preferred method of communication? *
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Gender*
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Race*
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Employment

Labor Force Status*
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Do you have children receiving Free/Reduced Lunch? *
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Are you receiving CalWorks (Medi-Cal/Medicare, CalFresh, EBT, WIC, any government assistance)?*
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Education

Highest Education Level*
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Highest Grade Level Completed*
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Have you ever received special education services?*
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Do you have an active IEP (Individualized Education Program)?*
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Majority of my schooling was outside of the U.S.*
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Goals

Primary Goal*
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Secondary Goal*
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Emergency Contact

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