Clark Advanced Learning Center - Online Application

Date required

Use MM/DD/YYYY format.

Student's Legal Last Name required

Student's Legal First Name required

Student's Middle Initial

Anticipated High School Graduation Year required

Student ID (if available)

Year Student Began 9th Grade required

Date of Birth required

Parent/Guardian Name required

Home Address required

City required

State required

Zipcode required

Mailing Address (if different from home address)

Mailing City

Mailing State

Mailing Zipcode

Parent Home Phone required

Parent Work Phone

Parent Cell Phone required

Student Cell Phone required

Parent Email Address required

Current School required

List by full name any sibling(s) who has/have attended Clark and/or are currently attending or applying

Academic area of interest required

Minimum 300 Word Essay: Why I want to attend Clark Advanced Learning Center required

By checking I acknowledge I have read and understand the Clark’s Admission Requirements. Permission is granted for Clark staff to review and verify school records. I further understand that this Application does not guarantee acceptance at Clark. required

Verification required

Online Application

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