Pre-Enrollment

Required Items
Bring these to the campus to register
  • Social Security Card
  • Birth Certificate
  • Proof of Residence
  • Withdrawal Form
  • Transcript or Report Card from previous school
  • Shot Records
NOTE: When you finish this page, you still MUST make an appointment with your campus to complete the registration process. This form is simply to make your appointment with the registrar pass more quickly.
Basic Information
Entered: Last update: Moved to Live:
Hover mouse over left column for help.
StudentStudent First Name  
Student Middle Name  
Student Last Name  
Nickname  
Generation  
Gender  
Ethnic Background  
Student Birthdate (m-d-yyyy)  
Social Security Number
or State ID Number		  
Address: Street 1  
Street 2  
City  
State  
Zip  
Home Phone  
Mobile Phone  
E-Mail  
How did you hear about us?  
Residence Campus  
Entered 9th Grade  
Single Parent / Pregnant Teen  
Mother First Name  
Middle Name  
Last Name  
Address Same as student address (if checked, do not fill in address below)  
Street 1  
Street 2  
City  
State  
Zip  
Home Phone  
Employer  
Work Phone  
Mobile Phone  
E-Mail  
Father First Name  
Middle Name  
Last Name  
Address Same as student address (if checked, do not fill in address below)  
Street 1  
Street 2  
City  
State  
Zip  
Home Phone  
Employer  
Work Phone  
Mobile Phone  
E-Mail  
Emergency
Contact
1		 First Name  
Middle Name  
Last Name  
Home Phone  
Work Phone  
Emergency
Contact
2		 First Name  
Middle Name  
Last Name  
Home Phone  
Work Phone