Student OSIS #:*

Last Name:*

First Name:*

Middle Initial:

High School Grade in SPRING 2023*

Date Of Birth:*

Are you a NEW or RETURNING Lehman CN student?*

Address:*

Apt No:

City:*

State:*

Zip Code:*

Home Phone #:

Cell Phone #:

Email Address:*

Verify Email Address:

Parent/Guardian Name:

Parent/Guardian Cell #:

Parent/Guardian Email Address:

Verify Parent/Guardian Email Address:

High School:*

HS Counselor:

HS Counselor Email Address:

Overall HS Average:

Course Selection 1: Please select your FIRST choice:*
Course Selection 2: Please select your SECOND choice:*

Will you be taking any Regents exams in August 2022? If so, which ones?

Have you participated in College Now previously?

Are you enrolled in any Advanced Placement (AP) courses at your HS? If so, which ones?

Will you be participating in any after-school extra-curricular activities (i.e. internship/job/sports/clubs)?

Comments :

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