ENROLLMENT FORM
Please complete this form to being the enrollment process of your student into the Graduation Alliance program. Submit one form per student.
Form Submitter Information
My First Name
My Last Name
My Phone
My Email
Student Information
Graduation Cohort
Please select...
2022
2023
2024
2025
Student First Name
Student Middle Name
Student Last Name
Student Grade Level
Please select...
9
10
11
12
School
Student Date of Birth (mm/dd/yyyy)
Student ID
504 Plan
Yes
No
IEP
Yes
No
Dropout Recovery Student
Yes
No
Parent/Guardian Contact Information
Parent/Guardian First Name
Parent/Guardian First Name
Parent/Guardian Phone Number
Email
Enrollment Information
Reason
Please select...
Expelled
Suspended or Expelled
Referred by a court
Pregnant or is a parent
Previously dropout
Determined by the district to be at-risk of dropping out
Start Date
End Date
Are you uploading the student's transcript?
Yes
No
Upload Transcript
Notes
Acknowledgement
Please select one of the following
This is the full set of class for the student to complete.
This is a partial list of classes for the student, an additional list of courses may be provided after further review.