Open School Enrollment Form
Thank you for your interest and trust in FlexED
Parent/Guardian Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Student Name
*
First Name
Last Name
Student Date of Birth
*
/
Month
/
Day
Year
Date
Grade
*
Please Select
2024 - 12th
2025 - 11th
2026 - 10th
2027 - 9th
2028 - 8th
2029 - 7th
2030 - 6th
2031 - 5th
2032 - 4th
2033 - 3rd
2034 - 2nd
2035 - 1st
2036 - K
Gender
*
Please Select
M-Male
F-Female
X-Not Selected
Ethnicity
*
Please Select
A Asian
B Black or African
I American Indian or Alaska Native
M Multiracial
P Hawaiian or Pacific Islander
W White
Hispanic/Latino
*
Yes
No
Submit
Should be Empty: