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Proposed Computerized Enrolment System

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Proposed Computerized Enrolment System
MANUAL COURSE ENROLLMENT FORM

MANUAL COURSE ENROLLMENT FORM

From our Home Page or our literature, please choose the type of course format you would like, select a subject area, choose the course(s) you would wish to enroll, and complete & mail this form to manually enroll for courses.

THE FOLLOWING SECTIONS MUST BE COMPLETED FOR MANUAL ENROLLMENT.
PERSONAL INFORMATION & LOG-IN INFORMATION

PERSONAL INFORMATION & LOG-IN INFORMATION

SSN* ______________-__________-______________ BIRTH DATE* ______/_______/__________ (Please see Privacy Policy for additional information.)

NAME* ______________________________________________________________________________________ Title / First Name / Middle Name / Last Name

ADDRESS* ____________________________________________________________________________________ Street / Apt. or Unit # / City / State / Zip

PHONE(s)* ___________________________________________________________________________________ Home Phone # / Cel Phone # / Other Phone #

EMAIL* ___________________________________________________@__________________________________

ALT EMAIL ________________________________________________@__________________________________

PASSWORD* _________________________________________________________________________________ (Please provide your Site Password, or create a Password here in order for us to manually enter you into our site.)

SCHOOL DISTRICT* ______________________________________ (Please email or call us if you are in the LAUSD)

PREVIOUS VANGUARD STUDENT: □ YES □ NO / PLEASE CHECK IF ANY OF THE ABOVE INFO HAS CHANGED □

COURSE INFORMATION – for MANUAL ENROLLMENT

COURSE

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