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Valparaiso High School New Student Information 2021-2022 School Year
Please make certain you live within the Valparaiso Community School district prior to registering for classes. You may verify this with either the VHS main office at 219-531-3070 or the Administration Office at 219-531-3000.
Please complete and submit the following information. Based on the information you provide you will be contacted by the Student Services Department personnel to make an appointment for enrollment and scheduling of classes. You will be contacted for an appointment after July 27, 2021.
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* Indica que la pregunta es obligatoria
Previously Attended School
*
Tu respuesta
Student's Last Name
*
Tu respuesta
Student's First Name
*
Tu respuesta
Preferred Name
Example: Michael - Mike
Tu respuesta
Gender
*
Female
Male
Student's Date of Birth
*
DD
/
MM
/
AAAA
Student's Birth City:
*
Tu respuesta
Student's Birth State:
*
Tu respuesta
Ethnicity
*
Check all that apply
Hispanic/Latino Ethnicity
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Obligatorio
Student's House Number
*
Example: 305
Tu respuesta
Student's Street Name
*
Example: Franklin St - please use abbreviation Ave, Ct, Dr, Ln, Pkwy, Pl, Rd, St, Ter
Tu respuesta
Apartment
Example: 1/A
Tu respuesta
Student's Zip Code
*
46383
46385
Phone number where you prefer to be contacted for this appointment.
*
Enter Primary Number In This Format: 219-531-3000
Tu respuesta
Select Phone Type
*
Cell
Landline
Custodial Parent Last Name, Mother's First Name/Father's First Name
*
Example: Smith, Jane/John
Tu respuesta
Custodial Parent Relationship
*
Father/Mother
Father Only
Mother Only
Father/Stepmother
Mother/Stepfather
Legal Guardian
Other
Custodial Parent's Email Address
*
Type: 'None' if you do not have email
Tu respuesta
Non-Custodial Parent's Email Address
Tu respuesta
Mother's Last Name
Tu respuesta
Mother's First Name
Tu respuesta
Mother's Primary Contact Number
*
Enter Primary Number In This Format: 219-531-3000
Tu respuesta
Select Phone Type
*
Cell
Landline
Father's Last Name
Tu respuesta
Father's First Name
Tu respuesta
Father's Primary Contact Number
*
Enter Primary Number In This Format: 219-531-3000
Tu respuesta
Select Phone Type
*
Cell
Landline
Is Engish the primary language spoken at home?
*
Yes
No
List other language(s) spoken at home
Tu respuesta
Does your child have any special needs
*
Yes
No
Has your child been evaluated or received services from Porter County Educational Services?
*
Please let us know if they attend SELF now or have in the past
Tu respuesta
Describe any special needs information
Tu respuesta
Does your child have siblings at this or any other VCS school?
*
Yes
No
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