Online Enrollment Form | Citizens High School

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CHS Diploma Enrollment
Choose One:*Is the course you are taking "Online" or "Offline"?
- Online - $129 per month
- Offline - $99 per month
Choose One:*Is the course you are taking counts toward "Diploma for College" or "Diploma for Career"?
- Diploma for College
- Diploma for Career
Choose One:*You preferred course language.
- Study in English
- Español Studies
Student Information
Student Name*
First Name Last Name
Email Address*
Phone*
Login Information
Your credentials to access your account.
Password*
Password Confirm Password

Minimum 8 characters required
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Admission Disclosure*
- I affirm receipt of the catalog/school handbook

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Basic Information
Study Type:	{Study Type:10}
Diploma For:	{Diploma For:9}
Language:	{Language:27}
Student Information
Name:	{Student Name (First):2.3} {Student Name (Last):2.6}
Email Address:	{Email Address:5}
Phone:	{Phone:4}

Enrollment Form