Student Registration : Information & Documents
Your responses will help NSH office staff start a file for your student.
Student's Name
*
First Name
Last Name
Middle Initial
Gender
*
Birth Date
*
-
Month
-
Day
Year
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Parent / Guardian Address & Contact Information
1. Parent / Guardian Name(s)
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
Confirmation Email
example@example.com
1. Phone Number
*
-
Area Code
Phone Number
1. Additional Phone Number
-
Area Code
Phone Number
Does the Student live at this address?
*
Yes
No
2. Parent / Guardian Name(s)
2. Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2. Does the Student live at this address?
Yes
No
Email
Confirmation Email
example@example.com
2. Phone Number
-
Area Code
Phone Number
2. Additional Phone Number
-
Area Code
Phone Number
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Emergency Contact
The Emergency Contact will be contacted if a Parent / Guardian is unavailable.
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Please list student's allergies, health concerns and/or medications.
Current or Most Recent School
School Name
*
Address
City
*
State
*
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Grade
*
Please Select
8
9
10
11
12
Last attendance date at this School
-
Month
-
Day
Year
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Required Documents
Pictures or scanned documents are acceptable.
Proof of Student's Name & Date of Birth
*
Browse Files
Drag and drop files here
Choose a file
ex. birth certificate or passport
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of
Proof of Residential Address
*
Browse Files
Drag and drop files here
Choose a file
ex. utility bill or lease
Cancel
of
Student's Immunization Record
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Transcript or Progress Report
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
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