2021/2022 Online Application

Applicant Infomation
*Student First Name
Student Middle Name
*Student Last Name
*Social Security Number

*Gender
*Date of Birth (mm/dd/yyyy)
/ /
*Street Address
Street Apartment #
*Street City
*Street State
Your street address must be located in Arkansas.
*Street Zip
*Required Fields
Mailing Information
Mail Address
Mail Apartment
Mail City
Mail State
Mail ZIP
Guardian or Parent Contact Information
Parent or Guardian
*Guardian or Parent Relation
*Parent or Guardian First Name
*Parent or Guardian Last Name
Parent or Guardian Employer
Parent or Guardian Work Phone
*Parent or Guardian Primary Phone
Parent or Guardian Cell Phone
Parent or Guardian Email
*Required Fields
Application Information
*Applying to Grade
*Ethnicity of Applicant
*First Choice School

Is there a sibling already in the first choice school?

*Second Choice School

Is there a sibling already in the second choice school?

*Third Choice School
Is there a sibling already in the third choice school?
yes
My child currently has siblings in the Texarkana Arkansas School District
yes
Please list the siblings in the Texarkana Arkansas School District
Sibling First Name
Sibling Last Name
Campus
Does the applicant require busing?
Does the applicant need special services?
*Current School
Any comments or notes
*Required Fields

Student selection will be done by random lottery. Submission may take a few moments. Please be patient