Pre-Application Form
Student:
Full name:
Current school:
Current grade:
8th
9th
10th
11th
12th
Currently under expulsion?
No
Yes
Ever skipped grade?
No
Yes
Has IEP plan?
No
Yes
Parent:
Full name:
Phone:
E-mail:
Relationship:
Mother
Father
Grandparent
Brother/Sister
Legal Guardian
How did you hear about us?
TV/Radio/Newspaper Ad
Friend
Search Engine
Bill Board
Brochure
Word of Mouth
Other
Why HSA?