Student Enrollment Application


Dolores Huerta Preparatory High

 

DISCLAMER!
I intend to enroll my child at Dolores Huerta Preparatory High. I have been explained the components of the curriculum as outlined in the brochure at www.cca-pueblo.org.

By filling out this form, you reserve your child a place in the lottery, but it does not obligate your child to attend.

PLEASE NOTE THAT IF YOUR ADDRESS OR PHONE NUMBER CHANGES, IT IS YOUR RESPONSIBILITY TO INFORM THE SCHOOL. YOUR CHILD MAY NOT BE ACCEPTED IF THIS INFORMATION IS NOT UP-TO-DATE.

 

ALL FIELDS ARE REQUIRED!

 

Enrollment
Childs first name
Childs last name
Childs middle name
Grade level in school year 2010-11
Childs date of birth
Parents military status
Last school child attended
Home address
City
State
Zip
Mothers last name
Mothers first name
Fathers last name
Fathers first name
Home telephone
Work telephone
Cell phone
Emergency phone 1
Emergency phone 2
Your e mail
Do you currently have a siblingattending or that has alredy been accepted to DHPH?
Siblings name
What grade are they in?
Is your child a candidate for the honors program
Does your child require special educational accomodations?
Other accomodations
From who or where did you here about DHPH?
Which Colorado county do you reside in?
Do you or your spouse work for the Federal Govt.
Will your child be eligable for the free or reduced lunch program?
Exrta curricular activities. Please check one. If your selection is a musical instument, please indicate what instrument in the provided field.
Other extra curricular activity
Musical instrument name
Submitted by
Submit date