Student Enrollment Academic Year 2019-2020 Please fill out the form below. Include student information as it appears in the school's record. FIRST NAME* MIDDLE NAME/INITIAL LAST NAME* PREFERRED NAME (IF DIFFERENT THAN ABOVE) BIRTH DATE* MM slash DD slash YYYY CURRENT ACADEMIC GRADE*89101112CURRENT SCHOOL ATTENDING*Alexander Hamilton High SchoolMentor ProgramAlliance Alice M. Baxter College-Ready High SchoolAlliance Collins Family College-Ready High SchoolAmbassador School of Global LeadershipBoys Academic Leadership AcademyNew Open World AcademySchool for the Visual Arts and HumanitiesUCLA Community SchoolHIGH SCHOOL ATTENDING* EXPECTED HIGH SCHOOL GRADUATION YEAR*2020202120222023GENDER*Gender-queer/Non-binaryManQuestioning or UnsureWomanTrans manTrans womanPrefer Not to DiscloseAdditional Gender Category Not Listed / OtherYOUR EMAIL ADDRESS* Enter Email Confirm Email HOME ADDRESS* Street Address Address Line 2 (Suite, Apt, Unit #) City State / Province / Region ZIP / Postal Code ETHNICITY*African American/BlackHispanic/Latino(a)CaucasianNative American-IndianAsianPacific IslanderMulti-racialOtherUnknownYou may select more than one.DO YOU QUALIFY FOR FREE OR REDUCED LUNCH?*YesNoWOULD YOU BE CONSIDERED A FIRST-GENERATION STUDENT?*YesNoFirst-generation students are the first in their family to graduate from college.PREFERRED LANGUAGE SPOKEN AT HOME* Information for Parent or Guardian #1PARENT/GUARDIAN FIRST NAME* PARENT/GUARDIAN LAST NAME* RELATIONSHIP TO STUDENT*MotherFatherSisterBrotherStep-motherStep-fatherAuntUncleGrandmotherGrandfatherMother-in-lawFather-in-lawFoster motherFoster fatherCousinCONTACT PHONE NUMBER*PHONE TYPE*Cellular PhoneHome (Primary)WorkEMAIL ADDRESS IN CASE OF EMERGENCY, MAY WE CONTACT THIS PERSON?*YesNoHIGHEST LEVEL OF EDUCATION COMPLETED BY PARENT/GUARDIAN #1*UnknownElementary SchoolMiddle SchoolHigh SchoolSome CollegeVocational or Trade CertificationAssociates DegreeBachelor's DegreeGraduate DegreeInformation for Parent or Guardian #2 (or Other Emergency Contact)This person must be different from the first parent or guardian you listed above. FIRST NAME LAST NAME RELATIONSHIP TO STUDENTMotherFatherSisterBrotherStep-motherStep-fatherAuntUncleGrandmotherGrandfatherMother-in-lawFather-in-lawFoster motherFoster fatherCousinCONTACT PHONE NUMBER*PHONE TYPECellular PhoneHome (Primary)WorkEMAIL ADDRESS IN CASE OF EMERGENCY, MAY WE CONTACT THIS PERSON?*YesNoHIGHEST LEVEL OF EDUCATION COMPLETED BY PARENT/GUARDIAN #2*UnknownElementary SchoolMiddle SchoolHigh SchoolSome CollegeVocational or Trade CertificationAssociates DegreeBachelor's DegreeGraduate Degree