Registration Form

Please Complete the registration form so we can process your child faster

Parents Name*
Child's Name
Child's Age
Address
City
State
Zip
Email
Phone Number
Night Phone Number
Will this be the first school your child attended?*
- Yes
- No
Name of School child has previously attended
Address and Phone number of school previously attended
Has your child ever been terminated or expelled from school? If your answer is yes, please explain below.*
Emergency Contact Information