Registration Form

School Year

Last Name

First Name

Middle Initial

Expected Grade Level

Birthdate

Birthplace

Sex

Nickname / Other Name

Street

City

State

Zip

I (the parent/guardian) affirm that I am an Arizona Resident

YesNo

Street or PO Box

City

State

Zip

Home PhoneCheck if unlisted

Name of Last School Attended

School Phone Number

Custody Issues

YesNo

IF YES - PLEASE PROVIDE COURT DOCUMENTS TO SCHOOL OFFICE

Name of Last School Attended

School Phone Number