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1.Parent Information
First Name:

Last Name:

Parent Email:

Address Line 1

Address Line 2

City:

State:

Zip/Postal Code:

Country:

Home Phone Number:

Fax Number:

2. Student Information
First Name:

Last Name:

Date of Birth:

EMail Address:

Current School Name

Current School Address, Phone and Fax Number:

PARENTS: PLEASE ANSWER

Why are you interested in an enrollment with us? Are you a prior home school family?

Has this student been identified with any special needs or learning challenges? If so, please explain.

 

 

 

 

 

STUDENTS: PLEASE ANSWER

Why do you feel you are a good candidate for our school?

Grade level for admissions

If registering for individual course, please select the course from the drop down menu
How did you hear about us?

 

 

 

 

 

 





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