Public and Charter Schools Registration Form
First Name
Middle Name
Last Name
Parent or Guardian's Full Name
Address
City
State
Zip Code
Student ID Number
Confirm Student ID Number
Primary phone Number
Secondary Phone Number
Email
Confirm Email
Name of School
Current Grade
Select the Student's Current Grade
K
1
2
3
4
5
6
7
8
9
10
11
12
Upload Student ID or Schedule or Report Card only
The student name and ID number must be visible and legible
Submit Registration
