ADMISSION APPLICATION FORM Stellar Preparatory High School 913 B Street, Hayward, CA 94541Telephone (415) 574-7082 Student Information Name * First Name Last Name Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Home or Cell # * (###) ### #### Email Date of Birth * MM DD YYYY Current School * Grade Level in Fall 2022 * Parent / Guardian Information Name * First Name Last Name Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Home or Cell # * (###) ### #### Email Electronic Signature * The statements and information furnished by the undersigned in this application form are true and complete. The undersigned applicant’s parent(s)/guardian(s) give permission for representatives of the sending school to release the applicant’s records including, grades, attendance, conduct/discipline records, as well as any other pertinent information that may be required by Stellar Preparatory for the purpose of admission. Our signatures certify that we have read and agree with the above statements. Signature of Student Signature of Parent Voluntary Information Section The information requested in this section is not required for admission. Submission of the information is entirely voluntary. Information submitted voluntarily by the applicant will not affect the applicant’s admission to the school. The information, if supplied, will be used for monitoring equal educational opportunity in the school. In addition, note that applicants with disabilities may voluntarily self-identify for the purpose of requesting reasonable accommodations during the entire application and admission process. Race: Select all that apply American Indian or Alaskan Native Asian or Pacific Islander Black White Hispanic Person with a disability No Yes If yes, Please list disability , and any accommodations needed: Person who is an English learner or limited English proficient: No Yes If yes, Please list language , and accommodations needed What is your favorite class in school? What is your grade point average? Do you want to attend college? Have you taken remedial courses? If yes, please list Do you have any special education needs? If yes, please list Do you have any language, or health concerns ? Upload Files FileField;MaxSize=5120;Multiple;addText=Add_your_Files; Add your Files Text Area * How Did You Hear About SPHS? We are excited about your submission to Stellar Preparatory High School. A representative will reach out to you shortly regarding next steps.Stellar Preparatory Administration