2023-2024 Grades K - 8 Initial Application Parrish Charter Academy

2023-24 Initial Application

Parrish Charter Academy

KG - 7th Grade

(941) 545-6380

Web: www.pcaedu.org
Student Information

Please submit only one application per student.
Student Last Name:*
Student First Name:*
Student Middle Name:
Grade for 2023-24 School Year*
Student Date of Birth:*

MonthDayYear
Student Gender:*

MaleFemale
Currently enrolled PCA sibling?*

YesNo
Current PCA Sibling Name:
Contact Information:
Mother/Guardian
Mother/Guardian Last Name:*
Mother/Guardian First Name:*
Mother/Guardian Email:*
Mother/Guardian Home Phone:*
Mother/Guardian Cell Phone:*
Father/Guardian:
Father/Guardian Last Name:*
Father/Guardian First Name:*
Father/Guardian Email:*
Father/Guarian Home Phone:*
Father/Guardian Cell Phone:*
Residing Address
Student Street Address*
City*
State*
Zip Code*
Last School Attended:
Please select last school attended:*
If other, list name, city and state of last school
How did you hear about PCA?*

OnlineFacebookAdvertisementEventFamily/FriendOther
I certify that the above enrollment information is true and accurate to the best of my knowledge.
Printed Name of Parent/Guardian*
Relationship:*
Date:*

MonthDayYear
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