2008-2009 E- Application

Please provide the following information for the student:

First name, middle initial, last name
Date of Birth
Sex	Male Female

Please provide the student's contact information:

Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Home Phone

Please select the grade the student will enter in 2008-2009:

6 7 8

Do you you wish to be contacted by e-mail? If yes, please provide your e-mail address in the space provided:

Please provide the student's ethnic background:

American Indian Asian Black Hispanic Multi Pacific Islander White

Mother's contact information

Name
Title
Place of employment
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail

Father's Contact Information

Name
Title
Place of employment
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail

Please list additional contact telephone numbers

Please list the last three schools attended by the student (most recent first, please). If your child has never attended a public school in Hillsborough County, please provide the name, address and phone number of the school(s) attended.

If you are applying for more than one child, please list the name(s) in the space provided, and the grade the student(s) will enter in 2008.2009:

Does the student require any special educational services? If so, please list in the space provided.

Name of person completing the application

What is your relationship to the student?

Mother Father Grandparent Guardian Sibling Other

Today's date

-- mm/dd/yy

How did you hear about us?

Advertisement Newspaper Word of Mouth Website School District Alumni Other My child is a sibling of a former student