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Urban Pathways 6-12 Student Application
This is an application. Completion of this form is not a guarantee of acceptance. In the event there are more applications received than space, the school will hold a lottery during a public meeting.
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* Indicates required question
Student First Name
*
Your answer
Student Last Name
*
Your answer
Student Middle Initial
Your answer
Birth Date
*
MM
/
DD
/
YYYY
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Current School Attending
Your answer
Current Grade Level
5
6
7
8
9
10
11
12
Clear selection
Applying for Grade Level
*
6
7
8
9
10
11
12
Applying For School Year
*
2024-2025
Mother/Guardian's Name
Your answer
Mother/Guardian's email
Your answer
Mother Guardian's phone number
Your answer
Father/Guardian's name
Your answer
Father/Guardian's email address
Your answer
Father/Guardian's phone number
Your answer
Are siblings attending UPCS 6-12?
Yes
No
Clear selection
Names of Siblings attending UPCS 6-12
Your answer
With whom does the student live?
*
Both Parents
Mother only
Father Only
Other:
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