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GMUHS 2021-2022 Registration Form
This form is for students entering GMUHS for the first time. Please fill it out entirely and submit it when finished. Please use one form for each student you would like to register.
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* Indicates required question
Email
*
Your email
Student's First Middle Last Name:
*
Your answer
Date of Birth:
*
MM
/
DD
/
YYYY
Male or Female
Male
Female
Race:
White
Black or African American
American Indian/Alaska Native
Asian
Native Hawaiian/Pacific Islander
Hispanic/Latino
Grade Entering:
*
7
8
9
10
11
12
Required
Student Lives with:
*
Both Parents
Mother
Father
Guardian
Other
Required
Parent/Guardian #1 Name:
*
Your answer
Physical Address:
*
Your answer
Mailing Address:
*
Your answer
Home Phone/Cell Phone
*
Your answer
Parent/Guardian #2 Name:
Your answer
Home Phone/Cell Phone
Your answer
Physical Address:
Your answer
Mailing Address:
Your answer
Does your child currently receive any services:
IEP
504
EST
Counseling
Current School Attending with Town/State
*
Your answer
A copy of your responses will be emailed to the address you provided.
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