Online Enrollment Form | Citizens High School

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All fields are required
Choose One:*Is the course you are taking "Online" or "Offline"?
- Online - $149 per month
- Offline - $159 per month
Choose One:*Is the course you are taking count towards the "Diploma for College (24-Credits)" or "Diploma for Career (18-Credits)"?
- Diploma for College
- Diploma for Career
Choose One:*Your 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
Have questions? Take a look at our Enrollment FAQ's before submitting.

View Student-Parent Handbook
Admission Disclosure*
- I confirm receipt of the Student-Parent Handbook and Catalog, linked above.

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