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SOUTHWEST PRIMARY - GRADES 4-6
SOUTHWEST INTERMEDIATE - GRADES 7-8
SOUTHWEST SECONDARY - GRADES 7-12
Letter of Intent
Use your Tab Key to move between fields, press submit or enter to send the form.
SCHOOL YEAR
Select the school year in which the student would like to start?
School Year 2011-12
School Year 2012-13
School Year 2013-14
School Year 2014-15
School Year 2015-16
STUDENT INFORMATION
Student Name:
Address:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
NE
ND
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
Phone:
Gender:
Male
Female
Birth Date (mo/day/yr):
School Last Attended:
Current Grade:
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Favorite Subject:
Year Entered 9th Grade:
PARENT/GUARDIAN INFORMATION
Mother's Name:
Address (if different):
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
NE
ND
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
Mother's Phone:
Mother's Cell Phone:
Mother's Employer:
Mother's Work Phone:
Mother's E-Mail Address:
Father's Name:
Address (if different):
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
NE
ND
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
Father's Phone:
Father's Cell Phone:
Father's Employer:
Father's Work Phone:
Father's E-Mail Address:
SIBLING INFORMATION
Sibling 1 Name:
Birth Date (mo/day/yr):
School Last Attended:
Current Grade:
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Sibling 2 Name:
Birth Date (mo/day/yr):
School Last Attended:
Current Grade:
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
ADDITIONAL INFORMATION