Student Application
Please complete this application with a parent or guardian. It should take 30 to 45 minutes to complete. Remember to click submit and print teacher recommendation forms!
Student Name *
Student Name
Home Address
Home Address
Home Phone
Home Phone
Cell Phone *
Cell Phone
Parent/Guardian #1 *
Parent/Guardian #1
Do you live with Parent 2?
Please break down your grades according to your courses: Example: English - B+
Hours and Minutes
Hours and Minutes
Hours and Minutes
Essay Requirements
Parent / Guardian Section
Please have two teachers complete the form below and mail to:

NJ LEEP, Inc.

570 Broad Street, Suite 700

Newark, NJ 07102

 

Or Fax to:  (973) 297-1508

 

Teacher Recommendation Form PDF