| Stoughton Academy Application
_____________________________________________
Last Name
First Name
MI
______________________________________________
Street Address
______________________________________________
City or Town
State Zip
______________________________________________
Day Phone/Evening Phone
_____________________________
School Last Attended
______________________________________________
Emergency ContactPhone
___________________________
Date of Birth
Last grade completed (circle) 8 9
10 11
If enrolled, I would be most interested in registering
for the following courses (circle choices).
English: I II III IV
Math: Basic Skills Consumer
Applications Algebra I Algebra
II Geometry
Science: Earth Science Biology
Chemistry Health Science & Nutrition
Social Studies: U.S. History I
U.S. History II American Government
Life Skills
Computer Skills: Computer Applications
______________________________________________ Signature
Date
|