2022-2023 Delta Student Application
Please complete the entire application and click SUBMIT at the end.  It is extremely important to enter accurate information.  If you cannot be contacted your seat at Delta will be forfeited.  Seats at Delta are very limited and interest is high.  Students are chosen by computerized lottery in March and will be notified at that time.  If you are not initially selected in the lottery you will be placed on a wait list for any available seats.  
**APPLICATIONS MUST BE RECEIVED BY 3:00 PM, THURSDAY, FEBRUARY 9TH, 2023. **
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Email *
NoStudent Last Name(s) *
Student First Name *
Student Email Address *
Student Date of Birth *
MM
/
DD
/
YYYY
Student Gender *
Current School Student ID # *
(if private school or homeschool, please enter "1111")
Student Home Address (Street) *
Student City *
Student Zip Code *
Student Phone Number (optional)
Please include area code
Student Ethnicity *
Current Middle School *
I live in the boundaries of the: *
If I do not attend Delta, my boundary high school is: *
My 8th grade math class is: *
I am currently on an IEP *
An IEP is a special education plan.
I am currently on a 504 plan *
A 504 is a health accommodation plan.
Parent/Guardian Name #1 *
Please include first and last names.
Parent/Guardian #1 Home/Cell Phone Number *
Please list the best number to contact this parent/guardian.
Parent/Guardian #1 Address
Only necessary if address is different than the address listed for the student.
Parent/Guardian #1 Email Address *
Language Spoken at home *
Second language spoken by parent/guardian? *
Parent/Guardian Name #2, if applicable
Please include first and last names.
Parent/Guardian #2 Home/Cell Phone Number
Please list the best number to contact this parent/guardian.
Parent/Guardian #2 Address
Only necessary if address is different than the address listed for the student.
Parent/Guardian #2 Email Address
YOUR EMAIL ADDRESS: What is the email address of the person filling out this form?   *
A copy of your responses will be emailed to the address you provided.
Submit
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