Fillable PRE-REGISTRATION INFORMATION FORM FOR ONLINE DISTRICT REGISTRATION (ODR)

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PRE-REGISTRATION INFORMATION FORM FOR ONLINE DISTRICT REGISTRATION (ODR)

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PRE-REGISTRATION INFORMATION FORM
FOR ONLINE DISTRICT REGISTRATION (ODR)
Rev. January 2020
The North Orange County Regional Occupational Program provides high-quality, relevant career technical education, and prepares all
students to succeed in employment, career advancement and further education. It is a joint venture of the Anaheim Union and Fullerton
Joint Union High School Districts and the Brea Olinda, Los Alamitos, and Placentia-Yorba Linda Unified School Districts.
Student Information
District Student ID #:
State ID # (CSIS):
Student First Name:
Student Last Name:
Student Address: Apt. #:
State:
California
City:
Zip Code:
Student Cell #:
Birthdate (mm/dd/yyy):
Student Personal Email Address (NOT school email):
Parent/Guardian Contact Information
Parent/Guardian First Name:
Parent/Guardian Last Name:
Relationship to Student:
Cell Phone Number:
Work Phone Number:
Personal Email Address:
School and Special Need Information
Home School District:
Home School:
Current Grade Level:
Ethnicity:
504 Plan**: Yes☐ No☐
IEP**: Yes ☐ No ☐
Note: **Please send the accommodation plan to the instructor.
CTE Pre-Registration
Class Location:
Course Title:
Course ID (see Regional Course Schedule):
CVE Students Only-Name of Current Employer:
Pathway Priority (circle one):
1 2 3 4
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PRE-REGISTRATION INFORMATION FORM FOR ONLINE DISTRICT REGISTRATION (ODR)

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Completed 18 January 2021

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