Bay Area Technology School - Online Application

APPLICATION INFO
Academic Year *	Select Value 2008-2009 2009-2010
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 English Albanian American Sign Language Arabic Armenian Assyrian Bosnian Burmese Cantonese Cebuano (Visayan) Chaldean Chamorro (Guamanian) Chaozhou (Chochow) Croatian Dutch Farsi (Persian) French German Greek Gujarati Hebrew Hindi Hmong Hungarian Ilocano Indonesian Italian Japanese Khmer (Cambodian) Khmu Korean Kurdish Lahu Lao Mandarin (Putonghua) Marshallese Mien (Yao) Mixteco Pashto Pilipino (Tagalog) Polish Portuguese Punjabi Rumanian Russian Samoan Serbo-Croatian (Serbian) Spanish Taiwanese Thai Tigrinya Toishanese Tongan Turkish Ukranian Urdu Vietnamese Other
Ethnicity *	Select Value African American or Black (not Hisp) American Indian or Alaskan Native Chinese Japanese Korean Vietnamese Asian Indian Laotian Cambocian Other Asian Filipino Hispanic or Latino Native Hawaiian Guamanian Tahilian Other Pacific Islander White (not of Hispanic origin) Declined to state No data entered Samoan Other
Birth date *
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