The Myrtle Beach STEM Academy Student Application Form

Academic Year

Grade Applying For

Student's Full Name

Date of Birth

Date

Current School

Current Grade Level

*For High School Students Only Our school offers STEM-focused pathways to help students prepare for future careers. Please select your 1st Choice for your pathway

Please select your 2nd Choice for your pathway (if you do not get into your first choice)

Please select your 3nd Choice for your pathway (if you do not get into your first choice)

*For High School Students Only Mandatory follow-up: Please tell us briefly why you selected these pathways and what you will add by being selected to the specific major?: (Paragraph response)

*For High School Students Only What career(s) are you currently interested in pursuing? (Paragraph or Short Answer) This gives insight into long-term student goals connected to their major

*For High School Students Only What career(s) are you currently interested in pursuing?

*For High School Students Only Previous Experience or Interests. Have you had any previous experiences related to your chosen majors (classes, clubs, camps, hobbies, etc?(Paragraph)

*For High School Students Only What skills or talents do you believe will help you succeed in your chosen pathway? Possible options:Public Speaking Creative Writing Coding Problem Solving Artistic Expression Critical Thinking

*For High School Students Only What skills or talents do you believe will help you succeed in your chosen pathway? Public Speaking Creative Writing Coding Problem Solving Artistic Expression Critical Thinking

*For High School Students Only What skills or talents do you believe will help you succeed in your chosen pathway? (Choose all that apply)

*Middle School and High School Preferred Learning Style or Work Environment. How do you learn best? (Choose all that apply)

*For High School Students OnlyPlease write a short statement about why you are interested in your chosen pathway and what you hope to achieve through it. (Paragraph)

Street Address

City

State

ZIP Code

Full Name

Relationship to Student

Phone Number

Format: (000) 000-0000.

Email Address

example@example.com

Parent/Guardian 2 (if applicable):

Full Name

Relationship to Student

Phone Number

Format: (000) 000-0000.

Email Address

example@example.com

Has your child previously applied to this school?

If yes what year

Has your child ever been suspended or expelled from any school(s)

If yes, please explain

Please briefly tell us why you want your child to attend our charter school and how you believe they would benefit from our learning environment

How did you hear about us?

REQUIRED DOCUMENTS (Submit when accepted)

Copy of Birth Certificate

Proof of Residency (utility bill, lease, etc)

Most Recent Report Card

IEP or 504 Plan (if applicable)

Please read and acknowledge the following

Submission of this application does not guarantee enrollment. Enrollment is offered based on seats available. If more applications are received than seats available for any particular grade, a lottery will be held to determine students offered a seat. If a seat is available, the family will receive notification and an enrollment packet to complete to accept the seat. All other applications will be placed on a waitlist. All applications are processed in accordance with the Charter Schools Act of 1996, as amended, and other applicable law.Myrtle Beach STEM Academy does not discriminate on the basis of race, creed, color, disability, sex, national origin, religion, pregnancy, or any other protected characteristic, as may be required by federal and state law in its admissions or any other school-related programs. We provide equal access to all designated youth serving organizations. Non-discrimination inquiries should be directed to Jayson Powers via Email - jpowers@myrtlebeachstemacademy.com Principal Title IX inquiries should be directed to the Myrtle Beach STEM Academy Title IX Coordinator - Jayson PowersEmail: jpowers@myrtlebeachstemacademy.com

I have read and understand the legal and enrollment disclaimer above.

By Submitting this Application:You are applying for the lottery into Myrtle Beach STEM Academy for the student’s placement for the grade indicated above. If there are more applications than seats available, your student will be assigned a number and entered into a lottery to determine placement in the school or wait list. If a seat is available for your student, you will receive notification and an enrollment packet with next steps for accepting the seat and enrolling.

ParentGuardian Signature

Date

The Myrtle Beach STEM Academy Student Application Form

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