2022-2023 Eva Legard Center for Coastal & Environmental Studies Application

Family Information
With whom does the applicant live?*

Both parentsMother onlyFather onlyLegal Guardian
Guardian 1 Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone*

Area CodePhone Number
Cell Phone*

Area CodePhone Number
Work Phone

Area CodePhone Number
Email*
Guardian 2 Information

Complete this section only if you wish to add a parent or legal guardian to the application. This person may serve as a secondary contact if we have questions regarding the application.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
Email

Sibling Information
Is there a sibling also applying on a separate application for this school?*

Yes (please fill out the additional information).No
Name*

First NameMiddle NameLast Name
Birth Date *

MonthDayYear
Date
2022-2023 Grade

Proofs of Residency
You must submit 2 current proofs of residency. The following documents will be accepted:
- Electric bill
- Gas bill
- Water/sewage bill
- Cable bill
- Residential phone bill
- Mortgage statement/homeowner's insurance
- Signed lease
For proofs of residency, do you prefer to hand deliver or upload the documents now?*

Hand deliver to the Office of InnovationUpload now
Proof of Residency 1

Cancelof
Proof of Residency 2

Cancelof
Should be Empty:

Student Information