Are you applying for the AIDE HS laptop program? This requires full time enrollment of 4-6 classes Yes
No
Students Last Name
Students First Name
Students Middle Initial
Date of Birth
Gender Male
Female
Contact Number
Students Email Address
Name, location of last school attended
School Phone
Last Grade Attended
Mailing Address
Name of person completing this form
Email address of person completing this form
Submit any questions you would like answered about enrolling in our program.
Electronic Signature: Please enter a 4 digit number to be used as your PIN/ and electronic signature