Dakota County Area Learning School-Application for Enrollment
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Student  First Name *
Student Last Name *
Gender *
Required
Date of Birth *
Father's Full Name *
Mother's Full Name *
Name of Parent/Guardian(with whom you reside) *
Home Address(Street, City, State, Zip) *
Home Phone Number *
Student Cell Phone Number *
Parent E-mail *
Father's daytime number *
Father's Cell number *
Mother's daytime number *
Mother's cell number *
Program Participation of Interest *
Required
Current/Home High School *
Current Grade *
Resident School District *
Receiving Special Ed Services *
Special Ed Case Manager *
Case Manager must send copy of current IEP
Applicant Signature *
By typing your name you are submitting this application for consideration of enrollment
Parent/Guardian Signature(if student is under 18 years of age) *
By typing your name you are submitting this application for consideration of enrollment
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