2025-26 Pinecrest Expedition Academy
New Student Application
Student Name
First Name
Middle Name
Last Name
Birth Date
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Month
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Year
Gender
Please Select
Male
Female
N/A
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent E-mail
example@example.com
Parent or Legal Guardian
First Name
Last Name
Parent or Legal Guardian
First Name
Last Name
Financial Guarantor
First Name
Last Name
Mobile Number
Phone Number
Work Number
Company
Last grade level completed:
Please Select
Pre-K
TK
K
1
2
3
4
5
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8
Last School Attended
Why are you applying to Pinecrest Expedition Academy?
Does your student have any of the following?
IEP
504 Plan
ISP
What is your child's favorite book?
Has your child had any discipline problems at school?
Please Select
Yes
No
Program Applying for
Please Select
Site Based (in person)
Independent Study (requires prior approval)
Birth Certificate and Immunization Records *If your child has previously been enrolled in any California school, you do not need to upload these records.
Browse Files
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Please submit a copy of your child's birth certificate and immunization records.
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Please List 3 References
Reference 1
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Reference 2
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Reference 3
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
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Application Fee
$
105.00
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Signature by signing this application and submitting payment I agree to the application process of Pinecrest Expedition Academy and understand my application fee is non-refundable regardless of acceptance. If accepted additional enrollment forms will be required.
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