Crystal Castle Learning Center
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Afghanistan
Albania
Algeria
American Samoa
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Anguilla
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Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
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Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
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Congo
Cook Islands
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Cote d'Ivoire
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Cuba
Curaçao
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Denmark
Djibouti
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Dominican Republic
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Egypt
El Salvador
Equatorial Guinea
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Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
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French Polynesia
Gabon
The Gambia
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Guadeloupe
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Guinea
Guinea-Bissau
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Israel
Italy
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Japan
Jersey
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Kenya
Kiribati
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South Korea
Kosovo
Kuwait
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Laos
Latvia
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Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
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Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
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Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
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Nepal
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Nigeria
Niue
Norfolk Island
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Northern Mariana
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Portugal
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Saint Barthelemy
Saint Helena
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Saint Lucia
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Samoa
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Sao Tome and Principe
Saudi Arabia
Senegal
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Seychelles
Sierra Leone
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Slovenia
Solomon Islands
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South Ossetia
South Sudan
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Sudan
Suriname
Svalbard
eSwatini
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Switzerland
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Taiwan
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Tanzania
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Timor-Leste
Togo
Tokelau
Tonga
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Parent's Phone
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Parent's Alt. Phone
Emergency Contact Phone Number
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Area Code
Phone Number
Alternate Emergency Phone Number
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Area Code
Phone Number
Email
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Does student suffer from any medical condition/disability that may affect his/her studies?
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Yes
If yes, please specify from the following
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Hearing
Learning
Mobility
Visual
Medical
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Does student have any physical limitations? Explain.
Does your student have siblings in or out of this school?
In this school
At another school
Not school age
Home schooled
No Siblings
How did you hear about us?
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Online Search
Facebook
Personal referral
Former student
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Any Known Allergies
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How does your child learn best?
What are your child's strengths and weaknesses?
What should we know about your student?
Do you agree to have your child comply with all current CDC guidelines for Covid 19 for the safety of all staff and students?
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Is your child fully vaccinated or do you have a current exemption on file?
Which learning method are you most interested in for your child?
Hands on learning
Whole child education
Project based learning
Learning through play
Self directed learning
Online program
Personalized curriculum
Traditional standards
Other
Child's grade level for 21-22 School Year
Previous School attended
Year Completed
County
Broward
Miami-Dade
Palm Beach
Out of State
Other
Preferred Schedule
5 full days (M-F)
Part Time 2 days
Part Time 3 days
Half day (2 or 3 days)
Half day 5 days
Afterschool Hours (2-6pm)
Online School Help
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Supporting Documents
Copy of Parent's Government Issued I.D. or License
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Anything else we should know about your student/family?
Declaration
For an applicant under the age of 18.
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I, the parent/guardian of the applicant hereby consent to this application for study
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