2024-2025 Registration
Student Information
Student Name
*
Date of Birth
*
/
Month
/
Day
Year
Now accepting students between 14-21 years old
Student Age
Please Select
13
14
15
16
17
18
19
20
21
Student Phone Number
Student Email Address
example@example.com
Student Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What Campus would you like to attend?
Please Select
Garfield Heights - Turney Road
Cleveland - Fulton Road
East Cleveland - Euclid Ave
Cleveland - St. Clair Ave
Unsure
We offer 4 convenient locations.
Parent/Guardian or Adult Student Signature
*
Today's Date
/
Month
/
Day
Year
Date
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Next
Student Educational Information
Name of Last School Attended
Last Grade Level Attempted
Please Select
8th
9th
10th
11th
12th
Student Race
Please Select
Asian
Black
White
American Indian
Alaska Native Hawaiian
Hispanic or Latino
Decline to answer
Does the student have an IEP or receive special services?
Please Select
Yes
No
Unsure
Decline to answer
Main Language Spoken at Home By Student
Please Select
English
Spanish
Other
Decline to Answer
Does the student have a 504 Plan or receive accommodations?
Please Select
Yes
No
Unsure
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Next
Parent/Guardian Information
Required for students 14-17 years of age
Parent/Guardian Name
Parent/Guardian Phone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
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Next
Emergency Medical Form
Emergency Contact Name
Relationship to Student
Please Select
Parent
Guardian
Grandparent
Adult Sibling
Aunt/Uncle
Other
Emergency Contact Cell Number
Relationship to Student
Please Select
Mother
Father
Guardian
Stepfather
Stepmother
Grandparent
Consent to Treatment at Closest Hospital
Yes
No
Hospital
Please Select
Cleveland Clinic - Marymount Hospital
Metrohealth
Closest Hospital
Doctor Name
Upload Proof of Residency
Browse Files
Drag and drop files here
Choose a file
Examples: Utility Bill (Gas, electric, water) Lease, Mortgage, Letter from Job and Family Services, Bank Statement
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of
Upload Birth Certificate
Browse Files
Drag and drop files here
Choose a file
Take a picture of your birth certificate and upload a copy. If you don't have a copy just let us know and we will order one for you.
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of
North Shore High School State Report Card
https://reportcard.education.ohio.gov/dorp/019220
Preview PDF
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