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Parent / Guardian Information
First Parent / Guardian Last Name * First Name * Salutation Email Address * Cell Phone (Ex: 999-999-9999)	Second Parent / Guardian (leave blank if not applicable) Last Name * First Name * Salutation Email Address * Cell Phone (Ex: 999-999-9999)

Home Phone * (Ex: 999-999-9999) How did you hear about Grandview? * Student 1 First Name * Last Name * Birthdate (mm/dd/yyyy) Gender Male Female Grade Level of Interest * School Year * Student Interests Extracurricular Activities Arts Athletics Dance Glee Club Student Government Tae Kwon Do Yearbook Other Clubs BETA Club Environmental Club Jr. National Honor Society Key Club Math Club SADD Spanish Honor Society National Honor Society Other Additional Interests Community Service Mentoring Other Current School * Is There Another Student? Yes No Parent / Guardian Notes