Online Application Form
Thursday, April 24, 2014
Horizon Science Academy Cleveland High School
6000 South Marginal Rd Cleveland, OH 44103
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Student Information

How did you hear us:
(Please tell us how you heard about our school)
Applying for:
Grade:
First name:
Middle: Last:
Birth date:
Race: Gender:
Home phone:
-- (Enter cell phone # if home phone is not available)
Address:
City:
State/Province:
Zip code:

Primary Parent/Guardian Information

Relationship to student:
First name:
Middle: Last:
Cell phone:
-- Work phone: ()-- Extension:
Email:
Address:
City:
State/Province:
Zip code:

Current School Information

Under expulsion:
(Is student currently under expulsion?)
Name:
Address:
Phone: ()-- Fax: ()--
or cancel