Lottery::Public Application

Option Selection

Learning Options (District transportation is provided to all District learning options) *

Current School *

Based on your resident address, what would be your boundary school for the 2021 - 2022 school year?

In preparation for this application, I have:

Shadowed a student in a learning option
Visited my neighborhood school
Talked with my counselor
Visited with students who currently attend my neighborhood school or one of the options
Other

General Info

Date of Birth *

Gender *

Current Grade *

Grade Entering Fall 2021 - 2022 *

Check box if student receives Special Education services

Residence

Home Address *

Apt. #

City *

State *

Zip Code *

Parent / Guardian Contact

Parent/Guardian Name *

Parent/Guardian Email *

Primary Phone *

Secondary Phone

Work Phone

Ethnicity/Race

This information is required by the federal government and is used for data analysis and reporting purposes only. If you choose not to respond, Beaverton School District is required to report this information through an observer identification process. COMPLETION OF PART A AND PART B IS REQUIRED.

Part A : Ethnicity (choose one)

NOT HISPANIC/LATINO
HISPANIC/LATINO - having origins in Cuba, Mexico, Puerto Rico, Central or South America or other Spanish culture or origin
Unanswered

Part B : RACE - NO MATTER WHAT YOU SELECTED ABOVE, PLEASE CONTINUE TO ANSWER THE FOLLOWING BY MARKING ONE OR MORE BOXES TO INDICATE WHAT YOU CONSIDER YOUR RACE TO BE.

AMERICAN INDIAN OR ALASKAN NATIVE – having origins in any of the original peoples of North and South America (including Central America), and who maintains Tribal affiliation or community attachment
ASIAN – having origins in the Far East, Southeast Asia or the Indian subcontinent, including Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, The Philippine Islands, Thailand and Vietnam
BLACK OR AFRICAN AMERICAN – having origins in any of the Black racial groups of Africa
NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER – having origins in any of the original Peoples of Hawaii, Guam, Samoa, or other Pacific Islands
WHITE – having origins in any of the original People of Europe, The Middle East, or North Africa

Agreement

By submitting this application I am assuring that I have given careful consideration to the options available and that I do reside in the Beaverton School District. *