STUDENT APPLICATION Applicant Information 2024-25 Name * First Name Last Name Are you new to the program? * Yes No Date of Birth * MM DD YYYY Name of High School , College or Trade School * Race Current Address * Address 1 Address 2 City State/Province Zip/Postal Code Country I Qualify For Free or Reduced Lunch * Yes No NA Current GPA * Grade * Freshman Sophomore Junior Senior Current Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Employed Yes No Emergency Contact Information Name First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Relationship * Parent/Legal Guardian Release By your signature you grant permission for your child to attend all student visits (To Be Determined) for the current school year. By your signature you give permission to The Tazel Institute (Leon Tazel III) to have access to your child’s GPA for the purpose of tracking academic progress. By your signature you also permit photos to be taken of your child during student visits, and celebratory activities. These photos can be used for marketing material of the High School and/or The Tazel Institute LLC. By signing you are also attesting that the information you have provided is true. Parent/Legal Guardian Signature:_______________________________ Date:____________ Student Behavior/Program Acceptance Student behavior in and out of the classroom must be acceptable by school standards. Should a student deviate from these standards, he may lose privileges of the program for a period of time or for the remainder of the school year. Acceptable behavior includes 1. Must achieve and maintain at least a 2.0 GPA 2. Must complete all class homework or assignments 3. Must complete program assignments by deadline given Student Signature:_______________________________ Parent/Legal Guardian Signature:_____________________________ Date:_____________ Student Signature * Parent/Legal Guardian Signature * Date * Thank you for your application.
