Guadalupe Academy Online Form

Guadalupe Academy Registration Form

Student Name *

First

Last

Date of Birth *

Gender

Age *

Grade

Parent Name (if applicable)

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email

School Attending

School District

City Council District

Number in Household

How did you hear about Guadalupe Academy classes?

What class/es is student taking?

Household Income

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