Register Your Home - East Allen County Schools

1)	*Which school does your child attend?:** Check any that apply	Heritage Jr./Sr. High School Leo Jr./Sr. High School New Haven High School New Haven Middle School Paul Harding High School Prince Chapman Academy Woodlan Jr./Sr. High School
2)	*First Name:**
3)	*Last Name:**
4)	*Spouse's Name:**
5)	*E-mail Address:**
6)	*Home Address:**
7)	*City:**
8)	*State:**	Indiana Ohio
9)	*Zipcode:**
10)	*Phone Number:**
11)	*Do you want your address and phone number published in the printed directory?:**	Yes No
12)	*Do you agree to the NAND Party Safe Pledge?:**	Yes No
*Required