Registration Form

Instructions: This form is part of the registration process.  Carefully complete this form and hit the submit button.

Upon submission of the registration form, you may be required to send more documents to complete the process. A Virtual Staff member will be in contact if additional documentation in needed to complete the enrollment process.

Basic Information
First Name: Middle Name:
Last Name: Preferred Name:
Gender: Date of Birth:

Street: City:
State: Country:
ZIP: Home Phone:
Email: Cell Phone:
Is the student a resident of St. James Parish? Citizenship:
Country of Birth:

Mailing Address
Copy from above City:
Street: State:
ZIP: Country:

Grade Level: Engagement Type:
School: Affiliation:
Local ID: Expected Graduation:

School Information
School Name: Parish:
Contact Name: Contact Phone:
Contact Email:    

Guardian 1 Guardian 2
Relationship: Relationship:
Last Name: Last Name:
First Name: First Name:
Email: Email:
Phone: Phone:

Additional Information
Which program are you interested in? Classification: