Register for On-line Access
iPass
Improving K-12 Education Through Software
2022-2023
Please only register 22-23 JUNIOR HIGH student(s). If you already have an account DO NOT RE-REGISTER!
How many students are you registering?
0
1
2
3
4
5
6
7
8
9
10
Personal Information
Title:
Mr.
Mrs.
Dr.
Ms.
Mx.
Miss
Gender:
Female
Male
*
First Name:
Middle Name:
*
Last Name:
*
Email:
Workplace:
*
indicates a required field.
Address Information
Type:
Home
Mail
Other
Student
Summer
Work
Street No:
Street Name:
Apt
Address 2:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
NOT IN US
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Zip Code
Telephone Numbers
*
Phone:
Ext:
Type:
Cell
Cell Alt
Home
Home Alt
Student
Work
Work Alt
Rank:
1
2
3
4
e.g. 999-999-9999
Phone:
Ext:
Type:
Cell
Cell Alt
Home
Home Alt
Student
Work
Work Alt
Rank:
1
2
3
4
Phone:
Ext:
Type:
Cell
Cell Alt
Home
Home Alt
Student
Work
Work Alt
Rank:
1
2
3
4
Phone:
Ext:
Type:
Cell
Cell Alt
Home
Home Alt
Student
Work
Work Alt
Rank:
1
2
3
4
Internet User Information
*
User ID:
The Password must be at least 6 characters long.
The Password cannot contain your User ID.
The Password must contain numbers.
*
Password:
*
Verify Password:
Primary Student Information
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
*
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Au Pair
Aunt
Aunt/Custody
Boyfriend
Brother
Daughter
Day Care Provider
DCF Worker
Domestic Partner
DYS Case Mgr
Educational Surrogate
Emergency Contact
Family
Father
Fiance
Foster Father
Foster Mother
Friend
Grandfather
Grandmother
Great Grandmother
Guardian
Hospital
Host Father
Host Mother
Husband
Mother
Neighbor
Other
Sister
Son
Stepfather
Stepmother
Uncle
Uncle/Custody
Wife
Additional Student 2
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
*
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Au Pair
Aunt
Aunt/Custody
Boyfriend
Brother
Daughter
Day Care Provider
DCF Worker
Domestic Partner
DYS Case Mgr
Educational Surrogate
Emergency Contact
Family
Father
Fiance
Foster Father
Foster Mother
Friend
Grandfather
Grandmother
Great Grandmother
Guardian
Hospital
Host Father
Host Mother
Husband
Mother
Neighbor
Other
Sister
Son
Stepfather
Stepmother
Uncle
Uncle/Custody
Wife
Additional Student 3
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
*
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Au Pair
Aunt
Aunt/Custody
Boyfriend
Brother
Daughter
Day Care Provider
DCF Worker
Domestic Partner
DYS Case Mgr
Educational Surrogate
Emergency Contact
Family
Father
Fiance
Foster Father
Foster Mother
Friend
Grandfather
Grandmother
Great Grandmother
Guardian
Hospital
Host Father
Host Mother
Husband
Mother
Neighbor
Other
Sister
Son
Stepfather
Stepmother
Uncle
Uncle/Custody
Wife
Additional Student 4
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
*
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Au Pair
Aunt
Aunt/Custody
Boyfriend
Brother
Daughter
Day Care Provider
DCF Worker
Domestic Partner
DYS Case Mgr
Educational Surrogate
Emergency Contact
Family
Father
Fiance
Foster Father
Foster Mother
Friend
Grandfather
Grandmother
Great Grandmother
Guardian
Hospital
Host Father
Host Mother
Husband
Mother
Neighbor
Other
Sister
Son
Stepfather
Stepmother
Uncle
Uncle/Custody
Wife
Additional Student 5
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
*
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Au Pair
Aunt
Aunt/Custody
Boyfriend
Brother
Daughter
Day Care Provider
DCF Worker
Domestic Partner
DYS Case Mgr
Educational Surrogate
Emergency Contact
Family
Father
Fiance
Foster Father
Foster Mother
Friend
Grandfather
Grandmother
Great Grandmother
Guardian
Hospital
Host Father
Host Mother
Husband
Mother
Neighbor
Other
Sister
Son
Stepfather
Stepmother
Uncle
Uncle/Custody
Wife
Additional Student 6
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
*
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Au Pair
Aunt
Aunt/Custody
Boyfriend
Brother
Daughter
Day Care Provider
DCF Worker
Domestic Partner
DYS Case Mgr
Educational Surrogate
Emergency Contact
Family
Father
Fiance
Foster Father
Foster Mother
Friend
Grandfather
Grandmother
Great Grandmother
Guardian
Hospital
Host Father
Host Mother
Husband
Mother
Neighbor
Other
Sister
Son
Stepfather
Stepmother
Uncle
Uncle/Custody
Wife
Additional Student 7
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
*
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Au Pair
Aunt
Aunt/Custody
Boyfriend
Brother
Daughter
Day Care Provider
DCF Worker
Domestic Partner
DYS Case Mgr
Educational Surrogate
Emergency Contact
Family
Father
Fiance
Foster Father
Foster Mother
Friend
Grandfather
Grandmother
Great Grandmother
Guardian
Hospital
Host Father
Host Mother
Husband
Mother
Neighbor
Other
Sister
Son
Stepfather
Stepmother
Uncle
Uncle/Custody
Wife
Additional Student 8
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
*
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Au Pair
Aunt
Aunt/Custody
Boyfriend
Brother
Daughter
Day Care Provider
DCF Worker
Domestic Partner
DYS Case Mgr
Educational Surrogate
Emergency Contact
Family
Father
Fiance
Foster Father
Foster Mother
Friend
Grandfather
Grandmother
Great Grandmother
Guardian
Hospital
Host Father
Host Mother
Husband
Mother
Neighbor
Other
Sister
Son
Stepfather
Stepmother
Uncle
Uncle/Custody
Wife
Additional Student 9
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
*
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Au Pair
Aunt
Aunt/Custody
Boyfriend
Brother
Daughter
Day Care Provider
DCF Worker
Domestic Partner
DYS Case Mgr
Educational Surrogate
Emergency Contact
Family
Father
Fiance
Foster Father
Foster Mother
Friend
Grandfather
Grandmother
Great Grandmother
Guardian
Hospital
Host Father
Host Mother
Husband
Mother
Neighbor
Other
Sister
Son
Stepfather
Stepmother
Uncle
Uncle/Custody
Wife
Additional Student 10
*
Student ID:
*
First Name:
Middle Name:
*
Last Name:
*
DOB:
e.g. mm/dd/yyyy
*
City of birth:
Student lives with me.
Relationship to Student:
Please select relationship
Au Pair
Aunt
Aunt/Custody
Boyfriend
Brother
Daughter
Day Care Provider
DCF Worker
Domestic Partner
DYS Case Mgr
Educational Surrogate
Emergency Contact
Family
Father
Fiance
Foster Father
Foster Mother
Friend
Grandfather
Grandmother
Great Grandmother
Guardian
Hospital
Host Father
Host Mother
Husband
Mother
Neighbor
Other
Sister
Son
Stepfather
Stepmother
Uncle
Uncle/Custody
Wife
