Public Application

Instructions
Please fill the form out and click on the Submit button to save your application.

If you have any questions, please contact us directly at [email protected] or call 503.614.1300



Application

Basic Information
First Name: Last Name:
Gender: Date of Birth:
Race: Ethnicity:
Mobile Phone Number:
Do you give ORVED permission to occasionally send SMS messages and acknowledge that data charges may be levied by your provider?
   
 

Address
Street: City:
State: Country:
ZIP: Dwelling Type:
Email:
Resident School District:    
       

Academic
Expected Graduation:
Curent Grade Level:
Last School Attended:
Local ID: 9th Grade Entry Year:

Guardians
Guardian 1 Guardian 2
Relationship: Relationship:
Last Name: Last Name:
First Name: First Name:
Email: Email:
Home Phone: Home Phone:
Work Phone: Work Phone:
Mobile Phone: Mobile Phone:
Do you give ORVED permission to occasionally send SMS messages and acknowledge that data charges may be levied by your provider? Do you give ORVED permission to occasionally send SMS messages and acknowledge that data charges may be levied by your provider?
Do you want an observer account? Do you want an observer account?

Additional Information
IEP: Section 504: