2023-2024 SVT Skill Center Enrollment Request
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Student Last Name *
Student First Name *
Student Birthdate     mm/dd/yyyy *
Gender *
Student Email *
Student Phone Number *
Mailing Address *
Parent/Guardian 1 Name  (First and Last) *
Parent/Guardian 1 Email *
Parent/Guardian 1 Phone Number *
Parent/Guardian 2 Name  (First and Last)
Parent/Guardian 2 Email
Parent/Guardian 2 Phone Number
Home High School *
Expected Year of Graduation *
What grade will you be in for the 2023-2024 school year? *
School Counselor's Name *
School Counselor's Email *
Student has an IEP (Individualized Education Plan).  Please send a copy to bhodgson@cvsd.org *
Student has a 504.  Please send a copy to bhodgson@cvsd.org *
Student has a Medical Alert.  Please send a copy to bhodgson@cvsd.org *
Race *
City / State / Country of Birth *
Will you be able to provide your own transportation? *
Course Enrollment (Choose 1)   Times subject to change based on school schedule. *
Alternate Course Enrollment if 1st Choice is Full *
Parent/Guardian Signature and Date *
Submit
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