EVENING PROGRAM APPLICATION

Student Information

Genderrequired

Students must be over the age of 18 in order to apply at One Bright Ray Community High School

Address

Staterequired

Check here if the Mailing Address is different

Scholastic

What was the last grade that you completed?required

What is the name of the last high school you attended?required

Based on your answer, Student Transcripts need to either be submitted online or in person to dermine eligibility

Student Transcripts

Do you receive Special Education services (IEP)?required

A completed IEP must be submitted either online or in-person to determine eligibility.

IEP

Which OBR Campus are you applying to attend?required

Which OBR Campus are you applying to attend? (#2)required

Which OBR Campus are you applying to attend? (#3)required

Error: You must not select the same campus twice. Please select unique values.

Race

Choose one or more:

Race(s)required

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or other Pacific Islander

White

Contact Information

Please list the e-mail addresses below that you would like communications sent to in order of importance.

Additional Information

If you wish to provide any more documentation during this Intake Application, please use this upload field here.

Additional Documents

Referral Sourcerequired

Electronic Signature

The electronic signature below, and all of its related fields, replaces a handwritten signature on paper and is legally binding.

I affirm that the information provided is true, correct and complete, to the best of my knowledge and belief. This electronic signature below and its related fields are treated by like a handwritten signature on a paper form.

I Agreerequired