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Winter School 2020 Registration
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* Indicates required question
Student First Name
*
Your answer
Student Last Name
*
Your answer
Student ID Number
Your answer
Street Address
*
Your answer
City
*
Your answer
Zip Code
*
Your answer
PARENT Name
*
Your answer
PARENT Phone Number ###-###-####
*
Your answer
PARENT Email Address
Your answer
STUDENT Phone Number ###-###-####
*
Your answer
STUDENT Personal Email Address
*
If Scranton School District student: please use your SSDEDU email account
Your answer
Does the student receive Special Education Services?
*
MARK ONLY 1
Yes, IEP
Yes, 504 Plan
No
Is the student an EL Learner
*
MARK ONLY 1
Yes
No
School the student currently attends
*
Your answer
Grade the student is currently in
*
2019 - 2020 School Year
9
10
11
12
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