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enrollment@intellischool.org

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Intelli-School
Graduation

Since Sept 1995
Computer based
High School curriculum

PASS
(Parent Access)
Ahwatukee
Glendale
Metro
Paradise Valley
Sweetwater



Pre-Registration

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Please fill out and submit the following pre-registration information.


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Are you a returning student?: Yes No

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Third Choice:
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Student Information
Last Name:   First Name:
SSN:
Date of Birth: / / Age:
Birth City, State: , Country:
Gender: Ethnicity:
Address:
City: Zip:
Home Phone: ()
Last School Attended:

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(Fields below are optional but will be required at a later date.)

Responsible Party Information
Mother's Contact Information
First Name: Last Name:
Work Phone: () ext:
Home Phone: ()
Cell Phone: ()
Address:
City, State: , Zip:
Father's Contact Information
First Name: Last Name:
Work Phone: () ext:
Home Phone: ()
Cell Phone: ()
Address:
City, State: , Zip:
Guardian's Contact Information
First Name: Last Name:
Work Phone: () ext:
Home Phone: ()
Cell Phone: ()
Address:
City, State: , Zip:
Emergency Contact Information
First Name: Last Name:
Relationship: Contact Phone: ()