2024-25 Application to Attend Zion-Benton East

Student's Last Name*
Student's First Name*
Student's Middle Initial
Student's gender. Pick one.*

MaleFemale
Birth Month*
Birth Date*
Birth Year*
Age*
Birth City*
Birth State*
Birth Country*
Home Language*
Mother/Legal Guardian's Name*
Father/Legal Guardian's Name*
Female Guardian's Relationship to Student*

MotherStep MotherFoster MotherGuardian
Male Guardian's Relationship to Student*

FatherStep FatherFoster FatherGuardian
Student's Ethnic Background

American IndianAsian Pacific IslanderBlackHispanicMultiPacific Islander/HawaiinWhite
Federal Race

American Indian/Alaskan NativeAsianBlackNative Hawaiian/Other Pacific IslanderWhite
Special Education Services

Yes
504 Plan/Services

Yes
Bilingual Support Services

Yes
Address*
City*
State*
Zip Code*
Mother's Cell Number*
Please enter a valid phone number.
Father's Cell Number*
Please enter a valid phone number.
Mother's Work Number*
Please enter a valid phone number.
Father's Work Number*
Please enter a valid phone number.
Mother's Email*
Father's Email*
Home Phone Number*
Please enter a valid phone number.
Student's Cell Number*
Please enter a valid phone number.
Student's Email*
example@example.com
Name of current school*
Applicant is a sibling of a current or past Zion-Benton East student.

Yes
Name of sibling who attended Zion-Benton East.
Sibling's Graduation Year.
All Freshmen take English, Math, Biology, Social Studies, Freshman Seminar, Spanish, and Physical Education or NJROTC. Please pick one.*

Physical Education (default)NJROTC - National Reserve Officer Training Corps
Band OR Choir may be taken as an overload instead of a study hall. Please pick one.*

BandChoirStudy Hall (default)
Optional, but highly recommended. After learning about what Zion-Benton East has to offer, please write a 150-250 word essay explaining why you would like to attend ZB East. Why do you feel ZB East fits your learning style and/or future goals? Students should write this essay in first person. If you prefer, you may attach a typed response to this application.
Signing and submitting this Application acknowledges that the Parent and Student have completed the application collaboratively. If accepted, the student commits to completing the four-year program at ZBE with the parent as an active partner in his or her education.
Parent/Legal Guardian's Signature*

Clear
Date*

MonthDayYear
Date
Student's Signature*

Clear
Date*

MonthDayYear
Date
Please upload a quick check proof of residency document that shows the student lives within District 126 boundaries and should be included in the selection process. A gas or electric bill or mortgage or lease papers are acceptable. If you do not have your document right now, you can email it to cheri.carter@zb126.org before January 31, 2025. This does not take the place of the full residency check which will take place over the summer during registration.
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