Today's Date
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MM
DD
YYYY
Name
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First Name
Last Name
Preferred Pronoun
Date of Birth
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MM
DD
YYYY
Race/Ethnicity
Cell Phone
*
(###)
###
####
Other Phone
(###)
###
####
Best Time to Reach You
Email Address
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Physical Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Mailing Address (If Different)
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Directions to Home
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Parent and/or Legal Guardian Name
First Name
Last Name
Phone Number of Parent and/or Legal Guardian
(###)
###
####
Legal Residence of Parent and/or Guardian
If you move, who is most likely to know how best to get in touch with you?
How can we reach them?
School Last Attended
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Grade Completed
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12
11
10
9
8
7
6
5
4
3
2
1
Other
Year
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Approximate Number of Credits Earned
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Why are you applying to Wayfinder Schools?
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Describe some personal goals you hope to accomplish while enrolled in Wayfinder Schools.
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What have been some of the most challenging parts about school for you lately?
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In your opinion, what is the primary cause of your challenges in school?
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What is it about Wayfinder Schools’ home-based Passages program you think might work better for you to achieve your high school diploma?
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I give permission to Wayfinder Schools to contact my former school and discuss my application and further enrollment with Wayfinder Schools.
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Name of former school
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Signature of applicant (if under 18, signature of legal guardian)
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Child #1's Name
Child's Date of Birth
MM
DD
YYYY
Other Birth Parent's Name
First Name
Last Name
Child #2's Name
Child's Date of Birth
MM
DD
YYYY
Other Birth Parent's Name
First Name
Last Name
Child #3's Name
Child's Date of Birth
MM
DD
YYYY
Other Birth Parent's Name
First Name
Last Name
Additional Children
Please include child's name, date of birth, and other birth parent's name.
Who are the present members of your household?
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How did you hear about Wayfinder Schools Passages Program?
Have you experienced, or are you currently experiencing any of the following? Check all that apply.
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Please list Referral, Friend, or Other
Why are you interested in the Passages Program now?
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Which agencies and/or programs are you involved with?
Are you currently employed?
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If so, where?
Wayfinder Schools complies with the Veterans Benefits and Transition Act of 2018, section 3679 of Title 38. Please let us know if you are entitled to Education Assistance under Chapter 31 Vocational Rehabilitation and Employment, or Chapter 31, Post 9/11 GI Bill Benefits.
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What is one thing you've always wanted to do and are determined to do in your lifetime?
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