Quest Program Application - Lake Washington School District

* indicates a required input

Student Information

First Name: *	Last Name: *	Middle Initial:
Birthday: (mm/dd/yyyy)*	Gender: *	Current Grade: *

School Information

Private School: (if it applies)	Neighborhood LWSD School: *
	For junior high parents: Choose the school where junior high students in your neighborhood attend
Private school address: (if it applies)
Current school teacher: *	Student special programs: IEP 504 Plan ELL
Student other special needs/accommodations:
Previous gifted participation:

Primary Guardian Information

First Name: *	Last Name: *	Middle Initial:
Street address: *
City: *	State: *	Zip Code: *
Home Phone: *	Work/Cell Phone: *	Other Phone:
Email: *

Secondary Guardian Information

First Name:	Last Name:	Middle Initial:
Street address:
City:	State:	Zip Code:
Home Phone:	Work/Cell Phone:	Other Phone:
Email:

*	I understand that I must complete this application process in full and must confirm the accuracy of the information I am submitting on this application. Any misrepresentation or false information provided will be cause for denial or revocation of participation in the Quest program.

How Do I...

The Lake Washington School District does not discriminate on the basis of race, color, national origin, sex, disability, age, gender, marital status, creed, religion, honorably discharged veteran, military status, sexual orientation including gender expression or identity, the presence of any sensory, mental or physical disability, or the use of a trained guide dog or service animal by a person with a disability, in its programs and activities and provides equal access to the Boy Scouts and other designated youth groups. Complete policy statement