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Student Application Form
Student First Name
Student Middle Name
Student Last Name
Student Preferred Name (if different)
Student's Age
Student's Date of Birth
Gender
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Grade Applying For
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Student's SSN (no dashes)
Year Applying For
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Parent / Guardian Type
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Parent/Guardian First Name
If legal guardian, relationship to student:
Parent/Guardian Middle Name
Parent/Guardian Last Name
Street Address
City
State
Apt / Unit
Zip code
Email
Phone
Employer
Occupation
Second Parent / Guardian Type
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Second Parent/Guardian First Name
If legal guardian, relationship to student:
Second Parent/Guardian Middle Name
Second Parent/Guardian Last Name
Street Address (if different than above)
City
State
Apt / Unit
Zip code
Email
Phone
Employer
Occupation
Student lives with:
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Please list name, age, grade, and school of siblings
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