NT Student Application 2012 - West Des Moines - West Des Moines ...
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NT Student Application 2012 - West Des Moines - West Des Moines ...
111th learner and thereafter will be selected for enrollment through a ... Street. City. State. Zip Code. Current West D
New Tech – Indian Hills Junior High Learner Application (2017-18) Applications can be submitted in person starting at 7 a.m. on Wednesday, Feb. 15, 2017, at Indian Hills Junior High, 9401 Indian Hills Drive, Clive, IA 50325. Applications will be accepted through Thursday, March 1, 2017, at 3 p.m. The first 110 learners to turn in an application will be immediately enrolled. The 111th learner and thereafter will be selected for enrollment through a stratified lottery. Please type or print neatly: Learner’s Name:
Gender: M Last
Learner’s Birth Date:
First
/ Month
Learner’s Email:
/ Day
F Age:
MI
Year
Home Phone Number:
Alternative Number:
Learner’s Current School of Attendance: Name of Parent(s)/Legal Guardian(s):
Parent/Guardian Email(s): (Please indicate which parent)
Parent/Guardian Contact Number(s): (Please indicate which parent)
Mailing Address: Street
City
State
Zip Code
Current West Des Moines Community School District Student ID: ___________ New Tech Grade Level Next Year (Circle One): 7th or 8th Currently in NTN (Circle One): Yes or No Learner Question: Why do you want to be on the New Tech team at Indian Hills Junior High? (Please provide your answer to the question in the space provided on the back side of this application.)
Our signatures below indicate that information about the model was made available to us and we are committing to attend New Tech — Indian Hills Junior High for at least one year. Parent Signature:
Date:
Learner Signature:
Date:
Office Use Only Received by:
Date:
Application Number: Page 1 of 2
Learner Question: Why do you want to be on the New Tech team at Indian Hills Junior High? (Please provide your answer to the question in the space provided below.) ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________
