Texas Success Academy- K-8 Admissions Application

Page 1 of 5 - Learner Information

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Learner Information

The information below will be used to create the learner's official record at Orion High School. Please provide the information as accurately as possible.
I am applying for:

I am applying for: K 1 2 3 4 5 6 7 8

Select 1 only.
Learner's Name Learner's Name First Middle Last
Date of Birth Date of Birth / MM / DD YYYY
Place of Birth
Last Four Digits of SS#, if in USA
Must be 4 digits. Currently Entered: 0 digits.
Gender
Race
Ethnicity
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number/International Phone Number
Provide an Additional Phone Number
Email (This is where your confirmation email for admissions will be sent, if you are the parent, please place your email address here)

Confirm Email Address
Save my progress and resume later
Enter Your Email Address *

A special link to resume the form will be sent to your email address.