Register for On-line Access
iPass
Improving K-12 Education Through Software
2022-2023
Please register all students at the same time.
Select the number of students you are registering:
0
1
2
3
4
5
6
7
8
9
10
Personal Information
Title:
Mr.
Mrs.
Dr.
Ms.
Miss
Gender:
Female
Male
*
First Name:
Middle Name:
*
Last Name:
*
Email:
Workplace:
*
indicates a required field.
Address Information
Type:
Home
Mailing
Other
Student
Summer
Work
Street No:
Street Name:
Apt
Address 2:
City:
State:
Not in US - Select a 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
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
Home
OneCall
OneCall2
OneCall3
OneCall4
Work
Rank:
1
2
3
4
e.g. 999-999-9999
Phone:
Ext:
Type:
Cell
Home
OneCall
OneCall2
OneCall3
OneCall4
Work
Rank:
1
2
3
4
Phone:
Ext:
Type:
Cell
Home
OneCall
OneCall2
OneCall3
OneCall4
Work
Rank:
1
2
3
4
Phone:
Ext:
Type:
Cell
Home
OneCall
OneCall2
OneCall3
OneCall4
Work
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.
*
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
Aunt
Daughter
Emergency Contact
Father
Foster Father
Foster Mother
Grandfather
Grandmother
Hospital
Host Father
Host Mother
Mother
Neighbor
Other
Son
Spouse
Stepfather
Stepmother
Uncle
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
Aunt
Daughter
Emergency Contact
Father
Foster Father
Foster Mother
Grandfather
Grandmother
Hospital
Host Father
Host Mother
Mother
Neighbor
Other
Son
Spouse
Stepfather
Stepmother
Uncle
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
Aunt
Daughter
Emergency Contact
Father
Foster Father
Foster Mother
Grandfather
Grandmother
Hospital
Host Father
Host Mother
Mother
Neighbor
Other
Son
Spouse
Stepfather
Stepmother
Uncle
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
Aunt
Daughter
Emergency Contact
Father
Foster Father
Foster Mother
Grandfather
Grandmother
Hospital
Host Father
Host Mother
Mother
Neighbor
Other
Son
Spouse
Stepfather
Stepmother
Uncle
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
Aunt
Daughter
Emergency Contact
Father
Foster Father
Foster Mother
Grandfather
Grandmother
Hospital
Host Father
Host Mother
Mother
Neighbor
Other
Son
Spouse
Stepfather
Stepmother
Uncle
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
Aunt
Daughter
Emergency Contact
Father
Foster Father
Foster Mother
Grandfather
Grandmother
Hospital
Host Father
Host Mother
Mother
Neighbor
Other
Son
Spouse
Stepfather
Stepmother
Uncle
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
Aunt
Daughter
Emergency Contact
Father
Foster Father
Foster Mother
Grandfather
Grandmother
Hospital
Host Father
Host Mother
Mother
Neighbor
Other
Son
Spouse
Stepfather
Stepmother
Uncle
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
Aunt
Daughter
Emergency Contact
Father
Foster Father
Foster Mother
Grandfather
Grandmother
Hospital
Host Father
Host Mother
Mother
Neighbor
Other
Son
Spouse
Stepfather
Stepmother
Uncle
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
Aunt
Daughter
Emergency Contact
Father
Foster Father
Foster Mother
Grandfather
Grandmother
Hospital
Host Father
Host Mother
Mother
Neighbor
Other
Son
Spouse
Stepfather
Stepmother
Uncle
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
Aunt
Daughter
Emergency Contact
Father
Foster Father
Foster Mother
Grandfather
Grandmother
Hospital
Host Father
Host Mother
Mother
Neighbor
Other
Son
Spouse
Stepfather
Stepmother
Uncle
