School Information
School Attending              Please select one Apex Dobie High School Sam Rayburn High School South Houston High School Pasadena High School Pasadena Memorial High School Tegeler Career Center The Summit Beverly Hills Intermediate Queens Intermediate South Houston Intermediate Bowie High School Channelview High School Cleburne High School Deer Park High School Dewalt Alternative Elsik High School Elsik 9th Grade Center Follett School Frenship High School Ferguson Junior High Friendswood High School Galveston Ball High Glenda Dawson High School Gunn Junior High Jimmy Carter HS Kerr High School LaJoya HS LaPorte High School LaPorte Junior High Lingleville School Lomax Junior High Lyford High School Mineral Wells High School New Diana High School Pearland High School Rio Hondo High School Sam Houston HS Valley View HS Venture Alter HS Other           I am taking this during the school day and this course is on my schedule. (check if true)       

Student Information

First Name   Last Name	ID	Gender Gender Female Male
Address	City	Zip
Home Phone	Cell Phone
Student Email Address  REQUIRED (if student does not have an email address use parents)
Birthday	Graduation Year choose YrA YrB YrC YrD YrE YrF YrG                Grade  choose 7 8 9 10 11 12
Counselor Name	Counselor Email
Course Name   Choose One Astronomy A First Semester Astronomy B Second Semester BCIS I-A First Semester BCIS I-B Second Semester Economics English IV-B Second Semester Government Health Music History A First Semester Music History B Second Semester US History A First Semester US History B Second Semester World Geography A First Semester World Geography B Second Semester TxVSN Course	School Year  choose ya-yb yb-yc	Session  choose Fall 1 Fall 2 Spring 3 Spring 4 Summer 5 TxVSN

 

Parent/Guardian Information

Name
Email Address
Work Phone	Cell Phone

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