Pathfinder Commitment Form

Pathfinder Tech Commitment Form
Do you accept our offer to attend Pathfinder? *
Student Information
Name

First Name Middle Name Last Name
Preferred Name
Please let us know if you identify by a name other the one just provided
Gender
Student Email
USE AN ADDRESS THAT IS NOT PROVIDED BY YOUR SENDING SCHOOL - SOME SCHOOLS BLOCK INCOMING MESSAGES
Residential Address

Street Address

Street Address Line 2

City State

Zip Code
Do you have a 2nd Address to add? (PO Box, etc)
Secondary Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student Primary Phone
Primary Phone Type
Student Secondary Phone
Secondary Phone Type
Date of Birth

Month Day Year
Date
City of Birth

Street Address

Street Address Line 2

City State
City of Residence

Street Address

Street Address Line 2

City State
Currently attending which school:
If other, please specify
Requires Student Services?
i.e. IEP, 504, etc
If "yes" new school must contact sending school system to assure continuation of special education program
Service Plan:
Please select a plan above
Students resides with
If other, describe below

Parent/Guardian Information
Parent/Guardian #1

First Name Last Name
Relationship to Student
Email
example@example.com
Parent/Guardian #1 Primary Phone

Area Code Phone Number
Primary Phone Type
Parent/Guardian #1 Secondary Phone

Area Code Phone Number
Secondary Phone Type
Occupation
Place of Employment
Does this person have legal custody of the student?
Does this person live in the same house as the student?
Parent/Guardian #1 Address

Street Address

Street Address Line 2

City State

Zip Code
This parent can receive communication from the school -- meaning there is no court order restricting access to the student's educational information.
Parent/Guardian #2

First Name Last Name
Relationship to the student
Parent/Guardian #2 Email
example@example.com
Parent/Guardian #2 Primary Phone

Area Code Phone Number
Phone Type
Parent/Guardian #2 Secondary Phone

Area Code Phone Number
Phone Type
Parent/Guardian #2 Occupation
Parent/Guardian #2 Place of Employment
Does this person have legal custody of the student?
Does this person live in the same house as the student?
Parent/Guardian #2 Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
This parent can receive communication from the school -- meaning there is no court order restricting access to the student's educational information.
Would you like to add another Parent/Guardian?
Parent/Guardian #3

First Name Last Name
Relationship to the student
Parent/Guardian #3 Email
example@example.com
Parent/Guardian #3 Primary Phone

Area Code Phone Number
Phone Type
Parent/Guardian #3 Secondary Phone

Area Code Phone Number
Phone Type
Does this person have legal custody of the student?
Does this person live in the same house as the student?
Parent/Guardian #3 Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
This parent can receive communication from the school -- meaning there is no court order restricting access to the student's educational information.
ATTENTION NON-CUSTODIAL PARENTS:

Please refer to 603 CMR 23.07
Do both parents have custody and parental rights with respect to this student?
If no, which of the following applies?

Mother guardian with joint custody Mother guardian with sole custody Father guardian with joint custody Father guardian with sole custody
Are there any court orders in effect with respect to this student that should concern the school?
If yes, explain:
Please upload the court order below

Browse Files

Cancel of
Would you like add an extra mailing address for a non-custodial parent?

Non-Custodial Parent Mailing Information
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Home Phone
Work Phone
Cell Number
Email
example@example.com

Honors Coursework
Have you taken Honors level coursework?
Are you interested in taking Honors level coursework?
Which subjects are you interested in? (Select all that apply)

English Math Science History

Congratulations!
T-Shirt Size
Thank you for choosing the Pathfinder competitive advantage!

You are about to embark on four years of exciting and engaging technical skills, relevant academic knowledge, and must-have professional skills that will help you reach your desired career pathway and lifestyle.

Welcome to the Pathfinder Tech family!

Thank you for completing this form.
Should be Empty:

Pathfinder Tech Commitment Form

Student Information

Parent/Guardian Information

Non-Custodial Parent Mailing Information

Demographic Information

Honors Coursework

Athletics

Congratulations!