Bay Area Technology School - Online Application

APPLICATION INFO
Academic Year *	Select Value 2009-2010 2010-2011
Grade Applying For *	Select Value 6 7 8 9 10
Current School *
APPLICANT INFO
First Name *
MI
Last Name *
Gender *	Select Value Male Female
Home language *	Select Value
Ethnicity *	Select Value
Birth date *	Exp: Apr 1, 99
Birth place *
Medical needs
CONTACT INFO
Phone *	(Primary contact phone)
Email
Mailing Address *
City *	<< Select Value Antioch Berkeley Concord Cupertino Dublin Emeryville Foster City Fremont Gilroy Hayward Livermore Napa Oakland Palo Alto Richmond San Francisco, city San Jose San Leandro San Mateo San Ramon Santa Clara Sonoma South San Francisco Walnut Creek
State *
Zip Code *
PARENT INFO
Lives with	Select Value Unknown Both Father Mother Other
Guardian
Father name *
Father contact
Mother name *
Mother contact
* Required fields