Collaborative Central Program Admission


Step 1

STEDY Admission


February-March: Applicants complete admission documentation for STEDY program acceptance.


STEDY Enrollment Form

Personal Information

* = required fields
Program*:
First Name*:
Middle Name*:
Last Name*:
Birth Date*:
Gender*:
Grade*:
Race*:
Birth Place (City/State/County)*:
Current High School of Attendance*:
Expected Year of Graduation*:
SAIS ID: (if known):
High School ID #:
High School Counselor Name*:
T - Shirt Size*:

Family Information

Student Physical Address*:
Student Mailing Address (if different)*:
City*:
State*:
Postal Code*:
Student Email Address*:
Student Cell:*:
Student Lives With*:

Parent/Guardian Name*:
Home Phone*:
Email Address*:
Cell Phone*:
Place of Employment*:
Work Phone*:
Mailing Address*:

Parent/Guardian Name:
Home Phone:
Email Address:
Cell Phone:
Place of Employment:
Work Phone:
Mailing Address:

Emergency Contact Information

Name*:
Relation*:
Phone*:

Name:
Relation:
Phone:

I hereby grant Southwest Technical Education District of Yuma (STEDY) staff permission, to summon emergency personnel. If is understood that the staff will contact by telephone the parents/guardian or other emergency contacts as listed above.


You're missing required information