GLBTQ Interested Student/Parent/Guardian

1. GLBTQ Online High School

Thank you for your interest in attending our school!

To be contacted by school personnel, please complete this one-page form. Someone from the school will contact you within a few days. All information is kept completely confidential.

This form is not a school application and carries with it no obligation.

Thanks very much! We look forward to talking with you!

1. Name of student

Name of student

2. Age of student

Age of student

3. Student grade level

Student grade level

Other (please specify)

4. Ideally, when would the student like to start classes?

Ideally, when would the student like to start classes?

5. Please complete the following. One of our administrators will contact you within 48 hours.

Please complete the following. One of our administrators will contact you within 48 hours. Name of person we should contact:
Relationship to student:
Phone number:
Email address:
Best time to call:

6. In order to maintain confidentiality, when we phone we will ask for and talk only to the people named on this form. We will not leave a message on a voice mail system or with anyone else unless you give us permission to do so. Please describe any such concerns you have here. Include names and relationships of people at the phone number you provided that we should or should not talk to about your interest in the GLBTQ Online High School.

In order to maintain confidentiality, when we phone we will ask for and talk only to the people named on this form. We will not leave a message on a voice mail system or with anyone else unless you give us permission to do so. Please describe any such concerns you have here. Include names and relationships of people at the phone number you provided that we should or should not talk to about your interest in the GLBTQ Online High School.

7. If you have any additional comments or questions, please include them below. Thank you very much!

If you have any additional comments or questions, please include them below. Thank you very much!