Language
English (US)
Spanish (Latin America)
Student's Last Name
*
Student's First Name
*
Student's Middle Initial
Student's gender. Pick one.
*
Male
Female
Birth Month
*
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
Birth Date
*
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Birth Year
*
Please Select
2010
2009
2008
2007
2006
2005
2004
2003
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
*
Mother
Step Mother
Foster Mother
Guardian
Male Guardian's Relationship to Student
*
Father
Step Father
Foster Father
Guardian
Student's Ethnic Background
American Indian
Asian Pacific Islander
Black
Hispanic
Multi
Pacific Islander/Hawaiin
White
Federal Race
American Indian/Alaskan Native
Asian
Black
Native Hawaiian/Other Pacific Islander
White
Special Education Services
Yes
504 Plan/Services
Yes
Bilingual Support Services
Yes
Address
*
City
*
State
*
Please Select
IL
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 New Tech student.
Yes
Name of current or past New Tech student
Class of
Please Select
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
I want to enroll in NJROTC instead of Physical Education.
Yes
I want to take Band. (Meets the same time as choir - cannot take both.)
Yes
I want to take Choir. (Meets the same time as band - cannot take both.)
Yes
Parent/Legal Guardian's Signature
*
Date
*
-
Month
-
Day
Year
Date
Student's Signature
*
Date
*
-
Month
-
Day
Year
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 February 9, 2024. This does not take the place of the full residency check which will take place over the summer during registration.
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