FlexTech Brighton Student Application
Please fill out this information to the best of your ability so that we have all necessary information to enroll the student at FlexTech High School
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Student First Name *
Student Last Name *
Student Gender *
Student's Grade Grade Level for Fall of 2021 *
Student's current school
Student Address (Street, Apt, CITY & ZIP): *
Student Email
Student Phone Number
Student Date of Birth *
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/
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/
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Guardian 1 First Name *
Guardian 1 Last Name *
Guardian 1 Relationship to Student *
Guardian 1 Email Address *
Guardian 1 Phone Number *
Guardian 1 Physical Address (if different from student)
Guardian 2 First Name
Guardian 2 Last Name
Guardian 2 Relationship to Student
Guardian 2 Email Address
Guardian 2 Phone Number
Guardian 2 Physical Address (if different from student)
Student Race *
Student Ethnicity *
Does the student receive have an IEP or 504? *
Required
Is your student's first language a language other than English? *
Does your student speak a language other than English at home? *
Has the student ever been suspended or expelled from school? *
If answering yes to the above question, please provide a brief description of incident below:
How did you hear about us? *
If a current/former student, family, or community member recommended FlexTech, please list their name(s) below:
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