High School Fall Semester Education 2018

Full-Time or Part-Time Student*

Student Name*

First Middle Last

Student Email*

Date of Birth*

Format: mm/dd/yyyy

Country of Birth*

Home Address*

Street Address Address Line 2 City State ZIP Code

Grade Next Fall*

Home Phone*

Gender*

Race/Ethnicity*

Primary Language*

Parent/Guardian Name*

Parent/Guardian Email*

Parent/Guardian Work Phone*

Student is Special Needs with IEP*

Yes
No

Student is Special Needs with 504*

Yes
No

Have you taken an Achieve course previously?

Yes
No

Select Subject #1*

Select Class #1 (Business and Career)

Select Class #1 (Health & P.E.)

Select Class #1 (Language Arts)

Select Class #1 (Math)

Select Class #1 (Fine Arts)

Select Class #1 (Science)

Select Class #1 (Social Studies)

Select Class #1 (World Languages)

Select Class #1 (Technology)

Select Class #1 (Dual Credit)

Select Subject #2

Select Class #2 (Business and Career)

Select Class #2 (Health & P.E.)

Select Class #2 (Language Arts)

Select Class #2 (Math)

Select Class #2 (Fine Arts)

Select Class #2 (Science)

Select Class #2 (Social Studies)

Select Class #2 (World Languages)

Select Class #2 (Technology)

Select Class #2 (Dual Credit)

Current School*

Current School Counselor*

Previous full time school or school where credits were earned*

Comments

How did you hear about us?*

I verify the above information is correct*

Yes

Fall 2018 full-time enrollment is now closed

Part Time Application

High School Fall Semester Registration 2018