Laney High School

Student Email Address

Prospective Student Information

Student First Name

Student Preferred First Name (if different than what is listed above)

Student Last Name

Student Birthdate

Student Gender

Mobile Phone

I opt in to receive text messages from regarding events, visitation, or application updates. (Standard messaging rates may apply.)

Yes

No

Academic Information

When would you like to enroll?

What is your intended level of study?

First-Year (First-time College Student)

Transfer (Current College Student)

School Information

Current High School or Most Recent High School

Current College or Most Recent College