Student Name* |
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Address* |
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Date of Birth* |
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Type of Admission* |
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Current Grade* |
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Grade in which student requests admission* |
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Current School* |
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Name of Parent/Guardian* |
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Relationship* |
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Parent/Guardian Cell Phone Number* |
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Parent/Guardian Home Phone Number* |
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Parent/Guardian Email* |
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Name of Parent/Guardian 2* |
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Is the applicant related to any student that currently attends The Barack Obama Green Charter HS? |
Yes No | | |
Please list the name of relative(s) |
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Name of person completing this form |
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