Admittance Application

Student's Name: *

First

Last

Address: *

Street Address • City • State • Zip Code

Email:

Phone:

Date of Birth: *

Gender: *

Grade Applying For: *

Choose the grade of school in which student will participate in during Fall school season.

Guardian 1 Name: *

First

Last

Please provide the first & last name of the mother/father or legal guardian of the student being enrolled.

Address: *

Street Address • City • State • Zip Code

Email *

Phone: *

Work Phone:

Employer / Position:

Guardian 2 Name:

First

Last

Please provide the first & last name of the mother/father or legal guardian of the student being enrolled.

Address:

Street Address • City • State • Zip Code

Phone:

Work Phone:

Employer / Position:

Please list out some goals for your child that your child may or may not be aware of:

Is Your Child Currently Enrolled In Home School?