Student Registration
Name: 


  1. Student Name


  1. Student ID #


  1. Date of Birth (Ex. 06/11/04)


  1. Mailing Address (Ex. 5301 Celebration Drive)


  1. City (Ex. Hope Mills)


  1. Zip Code (Ex. 28348)


  1. Mother's Name


  1. Mother's Cell Phone


  1. Mother's Email Address


  1. Father's Name


  1. Father's Cell Phone


  1. Father's Email Address


  1. What are your interests and hobbies?


  1. What sports do you play in high school?


  1. What clubs or organizations do you participate in?


  1. Write a short statement describing how you learn best.


  1. Having the desire to be in a class is crucial to succeeding in it. With that being said, why did you choose this class?


  1. What grade do you expect to EARN in this class?


  1. Do you have access to a computer and Internet outside of school?
    Yes
    No


  1. Do you have any medical needs?
    Yes
    No


  1. Do you have medical needs records on file with the school?
    Yes
    No


  1. What class period is this?
    1
    2
    3
    4





Christilyn Page
Gray's Creek High School
Hope Mills, NC