Delta/Greely Enrollment Application 2023-24

Only for Families NEW to the Delta/Greely program.

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Teaching Parent / Guardian

First

Last

Phone

Email

Username

Password

Optional

Other Parent / Guardian

First

Last

Phone

Mailing Address

Street

Line two

City

State

Zip code

Copy mailing address

Physical Address

Street

Line two

City

State

Zip code

Remove this Student

Student

First

Middle

Last

Suffix

Date of birth

Gender

Race

Has a 504 Plan

In Special Education with an IEP

Student, parent, or grandparent is a member of an American Indian or Alaska Native Tribe or Band

Has limited English language use (proficiency)

If yes, select the primary language the student speaks in the home

Grade Level for 2023-24

Last school attended

Will this student be dual-enrolled in another school?

Answer "Yes" if the student will be enrolled in another school at the same time.

Remove this Student

Student

First

Middle

Last

Suffix

Date of birth

Gender

Race

Has a 504 Plan

In Special Education with an IEP

Student, parent, or grandparent is a member of an American Indian or Alaska Native Tribe or Band

Has limited English language use (proficiency)

If yes, select the primary language the student speaks in the home

Grade Level for 2023-24

Last school attended

Will this student be dual-enrolled in another school?

Answer "Yes" if the student will be enrolled in another school at the same time.

If you have additional students to enroll, click the Add Additional Student button to add another student form. Add Additional Student

Family

How did you hear about us?

Additional referral information