Summer School Application
Paw Paw Schools
Dates: June 7 - July 18, 2023
Child's Name
*
First Name
Last Name
Sex
*
Male
Female
Race
*
Hispanic Origin
White
Black/African American
Asian
American Indian/ Alaskan Native
Pacific Islands
Birthdate
*
-
Month
-
Day
Year
Date
Age
*
For which courses are you requesting credit recovery? (Grades 9-12 Only)
Custodial Parent/Guardian
*
First Name
Last Name
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Day Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Second Parent/Guardian
First Name
Last Name
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Day Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Persons to contact in case of emergency if parent/guardian can't be reached:
Name
*
First Name
Last Name
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name
First Name
Last Name
Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Signature
Submit
Should be Empty: