2020/2021 Online Application


Applicant Information
*Student First Name
Student Middle Name
*Student Last Name
*Social Security Number
*Gender
*Date of Birth (mm/dd/yyyy)
/ /
*Street Address
Street Apartment #
*Street City
*Street State
*Street Zip
*Required Fields
Mailing Information
Mail Address
Mail Apartment
Mail City
Mail State
Mail ZIP
First Guardian or Parent Contact Information
Parent or Guardian
*Guardian or Parent Relation
*Parent or Guardian First Name
*Parent or Guardian Last Name
Mail Address
Mail City
Mail State
Mail ZIP
Language of Correspondence
Parent or Guardian Employer
Parent or Guardian Work Phone
*Parent or Guardian Primary Phone
*Parent or Guardian Alert Phone
Parent or Guardian Cell Phone
Parent or Guardian Email
Student Primarily Resides with this Guardian
*Required Fields
Second Guardian or Parent Contact Information
Second Parent or Guardian
Guardian or Parent Relation
Parent or Guardian First Name
Parent or Guardian Last Name
Mail Address
Mail City
Mail State
Mail ZIP
Language of Correspondence
Parent or Guardian Employer
Parent or Guardian Work Phone
Parent or Guardian Primary Phone
Parent or Guardian Alert Phone
Parent or Guardian Cell Phone
Parent or Guardian Email
Student Primarily Resides with this Guardian
*Required Fields
Information
*Ethnicity of Applicant
*Applying to Grade (2020/2021)
*First Choice School
Is there a sibling already in the first choice program?
*Second Choice School
Is there a sibling already in the second choice program?
*Third Choice School
Is there a sibling already in the third choice program?
My child currently has siblings in the Texarkana Arkansas School District
yes
Please list the siblings in the Texarkana Arkansas School District
Sibling First Name
Sibling Last Name
Campus
Does the applicant require busing?
Does the applicant need special services?
*Current School
Any comments or notes
*Required Fields

Student selection will be done by random lottery. Submission may take a few moments. Please be patient