Pend Oreille River School Student Application

Once this application is received, the student’s transcript, application and input from staff working with the student are reviewed and discussed in a team meeting. 

Those students deemed most appropriate for the program are enrolled, while others remain on the waiting list. A staff member will be in contact with you to communicate the teams’ decision.

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Student's Full Name *
Preferred name *
Pronouns you prefer *
Student's Phone Number *
Student's Address (where they live most of the time) *
Student's Personal Email Address *
DOB *
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1st Guardian's Name & relationship to student *
1st Guardian's Phone Number *
1st Guardian's Email *
2nd Guardian's Name & relationship to student
2nd Guardian's Phone Number
2nd Guardian's Email
Best method of contact *
Last School Attended (Name & Location) *
Grad Year *
Our students come to school for 3 hours Monday-Thursday, either in the morning or the afternoon. Which session are you interested in?  *
Do you have a 504 or IEP? *
Do you live in any of the following situations? *
Required
Who referred you to apply for the Alternative Program? (School Counselor, Principal, friend, relative, self etc.)
*
Have you talked with your current school about transferring? *
What are you interested in doing after high school? *
Why would you like to attend Pend Oreille River School? Please describe any struggles you have in your current school setting that has led you to seeking out our alternative program. *
Please check any of the attributes of our program below that you believe you are in need of in your education setting. *
Required
What date would you like to start? *
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Is there anything more you'd like to share about yourself? *
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