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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

Student Last Name*

Answer Required

Student First Name*

Answer Required

Student Home School Email*

Answer Required

Student Street Address*

Answer Required

Student City, State and Zip Code*

Answer Required

Student Home Phone Number*

Number Required

Student Cell Phone Number*

Number Required

Student Date of Birth*

Answer Required

Counselor Name*

Answer Required

Counselor Email Address*

Answer Required

Counselor Contact Phone Number*

Number Required

Courses

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

Answer Required

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

Answer Required

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

Answer Required

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

Answer Required

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

Answer Required

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

Answer Required

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

Answer Required

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

Answer Required

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

Answer Required

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

Answer Required

Yes

Forms to Submit

Student's Y-1 Form*

Answer Required

Choose a file or drag it here.

Student's Y-2 Form*

Answer Required

Choose a file or drag it here.

Student's Permanent Record*

Answer Required

Choose a file or drag it here.

Student's IEP/504 Form

Answer Required

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 *

Email Required