After-school Registration
Learning Smart IB preparation
Student Information
Name
First Name
Last Name
Gender
Please Select
Male
Female
Email Address
School
Grade
Have you previously applied to or attended this school?
Yes
No
If yes, what year?
Guardian
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Guardian Phone Number
-
Area Code
Phone Number
Student Phone Number
-
Area Code
Phone Number
Back
Next
IB Subject 1 please indicate HL or SL
IB Subject 2 please indicate HL or SL
IB Subject 3 please indicate HL or SL
IB Subject 4 please indicate HL or SL
IB Subject 5 please indicate HL or SL
IB Subject 6 please indicate HL or SL
Back
Next
Please list any of the following: Current medications, Medication allergies, Food allergies, Chronic health concerns.
Back
Next
Notes
Please inform the office of any other vital information you think they may need to know in the event of an emergency. Thank you.
Submit
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