OFFICIAL ADMISSION/REGISTRATION FORM
I am interested in attending the HSCL because _______________________
_____________________________________________________________
_____________________________________________________________.
STUDENT INFORMATION:
Full Legal Name_______________, _______________ _______________
(Last) (First) (Middle)
I like to be called_________________________. (Gender) M___ F___
Date of Birth ___/___/___ Place of Birth_________________________
Street Address_________________________________________________
City_________________ State__________ Zip_______County__________
Home Phone___________________ Cell Phone______________________
SS#__________________ Email__________________________________
EDUCATIONAL INFORMATION:
The school I presently attend is ___________________________________.
My current grade level is 9th_____ 10th_____ 11th_____ 12th_____
School Address ________________________________________________
City_________________ State__________ Zip_______County__________
School Phone__________________ Contact_________________________
How many years have you attended this school? ______________________
Why did you decide to leave? _____________________________________
_____________________________________________________________ _____________________________________________________________.
What public high school are you zoned for? __________________________
Why are you choosing to not attend this school? _____________________________________________________________
Who referred you to our school and why?____________________________
PARENT/GUARDIAN INFORMATION
Father __ Stepfather __ Guardian/Relationship ___/___________________
Full Name ___________________, ________________ _______________
(Last) (First) (Middle)
Mailing/Street Address___________________________________________
City___________________ State_________ Zip_______ County ________
Home Phone____________________ Cell Phone _____________________
SS# ___________________E-mail _________________________________
Occupation/Title_______________________/________________________
Employed by __________________________________________________
Business Address _______________________________________________
City ___________________State _________ Zip _______ County _______
Business Phone ______________ Business E-mail_____________________
Mother__ Stepmother__ Guardian/Relationship __/____________________
Full Name ____________________, _________________ ______________
(Last) (First) (Middle)
Mailing/Street Address___________________________________________
City___________________ State_________ Zip_______ County ________
Home Phone____________________ Cell Phone _____________________
SS# ___________________E-mail _________________________________
Occupation/Title_______________________/________________________
Employed by __________________________________________________
Business Address _______________________________________________
City ___________________State _________ Zip _______ County _______
Business Phone ______________ Business E-mail_____________________
RELATIVES THAT ARE/HAVE ATTENDED THE HSCL
Name ____________________ Relation ____________ Class of ________
____________________ ____________ ________
____________________ ____________ ________
____________________ ____________ ________
SIBLINGS AND SCHOOLS ATTENDED
Name _________________Age___ Grade___ School__________________
_________________ ___ ___ __________________
_________________ ___ ___ __________________
_________________ ___ ___ __________________