2024 Freedom School Application
Scholar's Name
First Name
Last Name
Last grade your child completed.
Please Select
Kindergarten
1
2
3
4
5
6
7
8
What school does your scholar attend?
Does your child have an IEP or 504
Please Select
IEP
504
No
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Name
First Name
Last Name
Parent/Guardian Phone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
Gender
Please Select
Male
Female
Allergies
Shirt Size
Please Select
Child small
child medium
child large
adult small
adult medium
adult large
adult xl
adult xxl
Language spoken at home
Recieves Free or Reduced Lunch
Please Select
Yes
No
Is your child a returning scholar?
Please Select
Yes
No
Reading proficiency level?
Please Select
Above grade level
At grade level
Below grade level
Emergency Contact Information
Contact #1
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Contact #2
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Scholar Pick Up
Please those individuals that are not already list that are may pick up your scholar
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
PLEASE NOTE: An application fee will be collected in April after students are selected for Freedom School 2024.
Save
Submit
Should be Empty: