Student Registration 2024-2025

Student Information

Genderrequired

Are you 22 years of age or older?required

Which school would you like to attend?required

Classroom Based (Highlands Community Charter School)
Independent Study (California Innovative Career Academy)

Do you have a U.S. High School Diploma?required

Yes
No

Why would you like to attend Highlands?required

High School Diploma Reason

How did you hear about Highlands?required

Would you like any extra information regarding the following?

Small Groups: Drug and Alcohol Recovery, General Support

Career Technical Education (CTE) Entrepreneurship, Child Development, Truck Driving, Cosmetology/Manicuring, Information Technology, Office Administration, Medical Office Adminstration, Medical Assisting, Construction, and more

College and Major Exploration: How to apply for college, how to apply for financial aid, etc.

Resume/Cover Letter assistance, applying for jobs, interviewing skills, etc.

Housing Questionnaire

What is your current living situation?required

Staterequired

Translated Housing Questionnaire

I have read and completed the housing questionnairerequired

Mailing Address

Is your mailing address different than the physical address listed above?required

Staterequired

Out of District Address

Your home address is not within the boundaries of California. You must be a California resident to register.

Invalid Address

Your home address cannot be verified. Please contact the school for assistance.

Enrolling School

Please select a school to continue with registration.

We have many locations, please find them here to find one near you!

Place of Birth

Countryrequired

Language

Do you speak English fluently?required

What language did you first learn to speak?required

What language do you most frequently read/speak at home?required

Ethnicity

Is the student Hispanic or Latino? (A person of Cuban, Mexican, Puerto Rican, South or Central America, or other Spanish Culture or origin, regardless of race.)required

This question is about ethnicity, not race.

Race

What is the student's primary race?required

If the student is multi-racial, please make up to four more race selections.

Race #2

Race #3

Race #4

Race #5

All Races selected above must be unique. One or more of your selections is not unique, please correct your choice(s) above.

Other

Previous Education

Would you like help processing your former transcripts for credits towards graduating?

Yes
No

Previous School Name

Were you expelled from your previous school (and never returned)?required

This question will have no effect upon your ability to enter into our school. This information is primarily for statistical purposes and helps us to provide additional services to students

Household Information

Are you a parent?required

Yes, I am a parent of children that are still minors or otherwise are considered dependents
Yes, I am a parent, but my children are all adults and not dependents
Yes, I am pregnant or I am a soon-to-be father
No, I have never been a parent or legal guardian

Including yourself, how many people currently live in your residence?required

ex. 3

How many members of your household are under the age of 18?required

Are you currently employed?

Yes, I am currently employed with one or more jobs
No, I am currently not employed

Do you have your own transportation to school?

Yes
No

Are you currently receiving public assistance benefits through a county? (ie CalFRESH/SNAP/etc.)required

What county is your DHA case within?required

Are you interested in receiving Public Assistance Benefits (ie CalFRESH/SNAP/etc.)?

Do you have access to a computer and the internet at home?required

How many times have you moved in the past 12 months?

ex. 0

What is your first parent's highest level of education?required

What is your second parent's highest level of education?required

Emergency Contact Information

Please list emergency contacts

Contact #1

Relationshiprequired

Contact #2

Relationshiprequired

Student's Medical Information

In case of emergency, do you give your consent for emergency procedures to be followed by the school? This care will be consistent with care needed and it is to be of an emergency nature only.required

Physician

Dentist

Health History

Do you have any allergies or medical considerations you would like us to know about?

Please list any other medical considerationsrequired

Characters Remaining:

Agreements

I grant permission to use pictures that include me for school purposes (ex. HCCTS.org, social media, etc.).required

I grant permission to use audio/video that has me in it for school purposes.required

I grant permission to use work produced by me for school purposes (ex. Projects/homework/etc.).required

I grant permission to release my information to any agency through which I'm on an assistance program (ex. DHA/HHSA/etc.).required

Are you potentially interested in going to college after finishing our program and would like to make your information available to colleges and universities?required

Are you potentially interested in a career in the U.S. military and would like your information shared with a military recruiter?required

I have access to and agree to the Student Handbook.

Student Handbookrequired

I confirm to have received the Charter School Complaint Notice.

Charter School Complaint Noticerequired

I grant permission to use my electronic signature below for all corresponding Independent Study compliance documents.required

Electronic Signature

The electronic signature below and its related fields are treated by Highlands Community Charter and Technical Schools like a handwritten signature on a paper form.

My signature indicates that the registration information I have provided is complete and accurate to the best of my knowledge.

I Agreerequired