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 11% of survey complete.
Student applications are accepted on a first come, first served basis. Please return this completed application to your school’s site lead.

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* 1. Session I - All schools listed below (May 31 - June 21)

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* 2. Session II - Vernon Only (July 8 - July 26)

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* 3. Student's First Name

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* 4. Student's Last Name

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* 5. Student's grade (School Year 2023-2024)

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* 6. Student's age

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* 7. Student's date of birth

Date

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* 8. Student's ID#

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* 9. Student's teacher's name

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* 10. Student's gender

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* 11. Student's home address

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* 12. Student's ethnicity

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* 13. Student's race. Please select only one.

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* 14. Please enter the name (first and last) of the student's parent/legal guardian:

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* 15. What is the above person's relationship to the student?

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* 16. What is the above person's home address,  email, and cell/home phone number?

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* 17. What is the above person's work phone number?

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* 18. If applicable, please enter the name (first and last) of the student's second parent/legal guardian:

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* 19. What is the above person's relationship to the student?

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* 20. What is the above person's home address, email, and cell/home phone number?

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* 21. What is the above person's work phone number?

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