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Full-Time Registration Form

Please complete the form below. Required fields marked with an asterisk *

Student Information for FULL TIME YABC

Student ID Number*

Answer required for "Student ID Number"

Student Last Name*

Answer required for "Student Last Name"

Student First Name*

Answer required for "Student First Name"

Student Home School Email*

Answer required for "Student Home School Email"

Student Street Address*

Answer required for "Student Street Address"

Student City, State and Zip Code*

Answer required for "Student City, State and Zip Code"

Student Home Phone Number*

Number Required

Student Cell Phone Number*

Number Required

Student Date of Birth*

Answer required for "Student Date of Birth"

Counselor Name*

Answer required for "Counselor Name"

Counselor Email Address*

Answer required for "Counselor Email Address"

Counselor Contact Phone Number*

Number Required

What accommodations does this student need?*

Answer required for "What accommodations does this student need?"

Courses

List all ELA courses; if N/A, then state N/A*

Answer required for "List all ELA courses; if N/A, then state N/A"

List all Social Studies courses; if N/A, then state N/A*

Answer required for "List all Social Studies courses; if N/A, then state N/A"

List all math courses; if N/A, then state N/A*

Answer required for "List all math courses; if N/A, then state N/A"

List all science courses; if N/A, then state N/A*

Answer required for "List all science courses; if N/A, then state N/A"

List all LOTE courses; if N/A, then state N/A

Answer required for "List all LOTE courses; if N/A, then state N/A"

List all PE courses; if N/A, then state N/A*

Answer required for "List all PE courses; if N/A, then state N/A"

List all Health courses; if N/A, then state N/A*

Answer required for "List all Health courses; if N/A, then state N/A"

List all Arts (this includes art, music, theater, and dance) courses; if N/A, then state N/A*

Answer required for "List all Arts (this includes art, music, theater, and dance) courses; if N/A, then state N/A"

List all Elective courses; if N/A, then state N/A*

Answer required for "List all Elective courses; if N/A, then state N/A"

My School Principal/Admin has approved this student's transfer to YABC.*

Answer required for "My School Principal/Admin has approved this student's transfer to YABC."

Yes

Forms to Submit

Student's Y-1 Form*

Answer required for "Student's Y-1 Form"

Choose a file or drag it here.

Student's Y-2 Form*

Answer required for "Student's Y-2 Form"

Choose a file or drag it here.

Student's Permanent Record*

Answer required for "Student's Permanent Record"

Choose a file or drag it here.

Student's IEP/504 Form

Answer required for "Student's IEP/504 Form"

Choose a file or drag it here.

Please report to George Westinghouse Campus the following school day to comeplete registration. Our address is 105 Tech Place, Brooklyn NY 11201

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"