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Parent/Guardian Full Name
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Parent/Guardian Email Address
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Parent/Guardian Phone Number
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Student Full Name
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Student Birth Date
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Student Email Address
Student Phone Number
Home Address
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- Street Address
- Address Line 2
- City
- State / Province / Region
- Postal / Zip Code
- Country
Student Gender
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Expected Student Interests/Needs
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Planned Enrollment Type
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Grade Level Needed
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How did you hear about Gateway Online School?
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Gateway Online High School Application Form