Cypress College Prep Student Application Form

Date of Application*
DD slash MM slash YYYY
Term*
Please Select the term you are applying for from the drop down menu below
Student Information
Student Name (as appears on transcripts)*
First (Given Name) Middle Last (Family Name)
Preferred Name (if any)
Student's Date of Birth*
DD slash MM slash YYYY
Gender*
Expected Year of Graduation*
Grade applying for:*
Student Email*
Student Phone*
Parent Information
Who does the student currently live with?*
- Both Parents
- Mother
- Father
- Boarding School
- Other relative or guardian
Father's Name*
First Last
Father's Email*
Father's Employer
Father's Mobile Phone*
Mother's Name*
First Last
Mother's Email*
Mother's Employer
Mother's Mobile Phone*
Student's Address*
Street Address Address Line 2 City State ZIP Code
We would like to thank the person who referred you to HBA so please type their name below.
We would like to thank the person who referred you to HBA so please type their name below.
Photo Release*
From time to time we take pictures of class activities to post on our website or Facebook page. We would appreciate it if you would allow use to your child's image (no names) without prior consent.
- I agree to allow my child to be photographed for promotional purposes on our website, Facebook page, or printed materials
Academic History
Name of current or most recent school:*
City and State of Current School?
Which grades did you attend at your current school?
Current or most recent grade level:*
Please list any other schools attended in grades 9 through 12:
Transcripts*
Please upload your student's transcripts for grades 9 through 12. If applying for grade 9, upload transcripts for grades 7 and 8. Transcripts may also be emailed to: studyhut@highbluffacademy.com
Max. file size: 50 MB.
HBA Student Contract Form
Max. file size: 50 MB.
Class schedule*
Please upload your student's class schedule/timetable.
Max. file size: 50 MB.
Is there any information you would like to share with us about your child?
Special Needs*
Does your child have any of the following that you know of:
Explain
If you checked any of the above, please give a brief description below:
Has the student been expelled or asked not to continue at any other school? If yes, please explain the circumstances.*
Has the student ever been arrested and/or put on probation? If yes, please explain below.*
Immunization Record*
The State of California requires certain immunizations to attend school. Please upload your child's immunization records and we will notify you of any additional vaccinations that are required if your child chooses to attend HBA. These records may also be emailed to: admissions@highbluffacademy.com once the student is admitted.
Max. file size: 50 MB.
Application Signature
Electronic Signature*
By typing your full name below, you assert that all information on this application is true to the best of your knowledge.
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Cypress College Prep Student Application Form

Cypress College Prep Student Application Form

Student Information

Parent Information

Academic History

Application Signature