Stanford University EPGY Online High School
 
 

Applicant Information Form

Submission of the Applicant Information Form is the first step in the application process. This form will generate your EPGY OHS Application Number, which you will need in order to submit the EPGY OHS Application. All fields for Student and at least one Parent/Guardian are required.

Student Information

 
Student Name
  first name middle name last/family name
Date of Birth
Phone number
Sex Expected Year of
High School graduation
 
Home Address
City  Postal Code
Country State
 
Student's Country of Citizenship
 
Student's Email Address
 
 

Parent Information

First Parent/Guardian (Required)
Parent/Guardian Name
 
  first name last/family name  
 
Permanent Address
Street Address
City  Postal Code
Country State
 
Mailing Address
Street Address / Box (Same as permanent address)
City  Postal Code
Country State
 
Parent Email Address
 
Home Phone    Work Phone      Cell Phone  
 
 

Second Parent/Guardian
Parent/Guardian Name
 
  first name last/family name  
 
Permanent Address
Street Address
City  Postal Code
Country State
 
Mailing Address
Street Address / Box (Same as permanent address)
City  Postal Code
Country State
 
Parent Email Address
 
Home Phone    Work Phone      Cell Phone  
 
 
How did you learn about the EPGY Online High School at Stanford University? (Check all that apply.)
The EPGY mailer
The EPGY web site
Newspaper
Radio or TV
From a friend or family member
I have taken EPGY classes before
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Other
 
 
Is there any additional information we should know regarding how to contact the student or parent(s)?
(500 character maximum)
chars left