Course Registration Form

Student Pre-Registration Form

2022-2023 School Year
Student Name

First Name Middle Name Last Name
Parent/Guardian Name #1

First Name Last Name
Parent/Guardian Name #2 (If Applicable)

First Name Last Name
Birth Date

Month Day Year
Gender
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent E-mail
example@example.com
Phone Number
Alternate Phone Number
Would you like a tour of the School?
Tour Choice
Additional Comments
Should be Empty:

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