Complete the following fields accurately and completely. You only get one chance to submit the information. Thanks!
First Name: Last Name:
APES Period: 2 5
Homeroom Room Number: Homeroom Teacher:
Student ID Number:
Email Address:
Mother's (or guardian's) Full Name (both first and last names):
Mother's (or guardian's) Email Address:
Mother's Work Phone Number:
Father's Full Name:
Father's Email Address:
Father's Work Phone Number:
I live primarily with . . . both parents mom only dad only
Double check your information before clicking "Submit"
