North Tech Mini-SIS

*All highlighted fields are required.

Please note, St. Louis City residents are not eligible to attend North Tech.

Student Information

Last Name:

First Name:

Middle Initial:
Address:

Apt. No.:
City:

Zip Code:

Gender:

Birthdate:

Phone:

Hispanic:

Race:

Program Choice:

Present School Name:

Current Grade Level:

Student Email:

Parent or Guardian Information

Last Name:

First Name:

Phone:

Email:

Emergency Contact Information

Last Name:

First Name:

Relationship:

Phone:

PARENTAL APPROVAL: I approve this application to North Technical High School. I also give permission for release of the transcript of records and all pertinent data relating to this application. I understand students must meet attendance and conduct standards.

Date: 06-19-13
Student Signature:

Parent/Guardian Signature:

Non-Discrimination and Accommodation
Special School District does not discriminate or tolerate discrimination based on race, color, religion, sex, national origin, sexual orientation, ancestry, disability, veteran status, age, or activity protected by federal or state law in its programs, activities and employment. Direct inquires and complaints under this policy to Special School District's Compliance Coordinator, 12110 Clayton Road, St. Louis, Missouri 63131; telephone 314.989.8100 or to the Office of Civil Rights, 8930 Ward Parkway, Suite 2037, Kansas City , Mo. 64114-3302; telephone 816.268.0550. Information about the existence and location of services, activities, and facilities accessible to impaired persons can be obtained from Special School District's Compliance Coordinator at the phone number and address listed above.