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Middle School/High School Student Registration

Student Information

Choose*

Answer Required

New Student

Returning Student

Todays Date*

Answer Required

Students Legal First Name*

Answer Required

Students Legal Middle Name

Answer Required

Students Legal Last Name*

Answer Required

Preferred Name

Answer Required

Grade Entering*

Answer Required

Date of Birth*

Answer Required

First language spoken by student*

Answer Required

Languages spoken at home*

Answer Required

Address

Street Address*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Home Phone*

Number Required

Parent/Guardian 1 Information

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

Email*

Answer Required

Mobile Phone*

Number Required

Work Phone

Number Required

Parent/Guardian 2 Information

First Name

Answer Required

Middle Name

Answer Required

Last Name

Answer Required

Question

Answer Required

Mobile Phone

Number Required

Work Phone

Number Required

Emergency Contact Information

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

Relationship to Student*

Answer Required

Email*

Answer Required

Phone*

Number Required

Family Doctor Information

Name

Answer Required

Phone

Number Required

This is the inital form for enollment. Additional documents are required. Please call the Middle School/High school Secretary at 509-246-1201 for more information on how to enroll your student. Thank you

Confirmation Email

Email Required