Application Form
Student Information
Student's Full Legal Name: ____________________________________
Nickname: ________________________________________________
Date of Birth: __________________________________Sex: ________
Mailing Address: ____________________________________________
Citizenship: ________________________________________________
School Name: ______________________________________________
Current Grade: _____________________________________________
E-mail Address: ____________________________________________
Parents'/Guardians' Names: ____________________________________
Parents'/Guardians' Home Phone: _______________________________
Parents'/Guardians' E-mail Address:______________________________
Alternate Emergency Contact: __________________________________
Emergency Contact Phone: ____________________________________