Apply for DATA 2008-2009
To apply for 2007-2008 Please call for availability (954) 767-0403
Student information:
Student Name
Last Name
Date of Birth
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Sex
Select
Male
Female
Nationality
Select One
White non-Hispanic
Black non-Hispanic
Hispanic
Asia/Pacific Islands
Native American
Multi Racial
Other
Last School Attended
Student Number
Grade Student will enter in DATA
6th
7th
8th
Street Address
City:
St
Zip
Parent / Legal Guardian Information:
Email
Mother/Legal Guardian
Home Phone
Cell Phone
Work Phone
Father/Legal Guardian
Home Phone
Cell Phone
Work Phone