WASHINGTON
HIGH SCHOOL
Information Request
* indicates a required item
Date:
*Student Last Name:
*First Name:
*Current School:
*Parent/Guardian Last Name:
*First Name:
Title:
Mr.
Ms.
Mrs.
Other, please specify
*Address:
*City:
*Zip:
*Home Phone #
Work Phone #
Email Address:
Additional information
I am interested in the WHS Early Admission Program
Yes
No
I'm not sure
I am in the PAT program at my current school
Yes
No
I'm not sure
I would like information on Technology Saturdays Program
Yes
No
I have a relative who goes to or has graduated from WHS
Yes
No
I'm not sure
I learned about this web site from (check as many as apply)
a billboard
a newspaper ad
a radio ad
a friend
In the area to the right, enter any other information you would like to share with us
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last modified: 8/8/2002:jk
