A randomly selected number of parents/guardians will be able to participate in the pilot online Choices Application Process for the 2012-2013 school year. Please fill out the following information if you are interested in participating. (Note: Indicating interest and filling out the requested information below, does not guarantee that you will be selected to participate.) Please refer to your child's 2011-2012 Acceptance, Wait or Late List Letter for the Application and Reference numbers.

* Choices Application # for 2011-2012:   What is this?

Student Reference #:   What is this?

Parent/Guardian Name:

Parent/Guardian e-mail:

Confirm Parent/Guardian e-mail:

* This pilot will only be available to students with valid 2011-2012 Choices Applications on file.

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For further assistance, please contact (213)241-4177.