FLORIDA METROPOLITAN TRANSITIONAL ACADEMY

Registration Form

Fill out the form carefully for registration
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Ethnicity *
Are you of Hispanic origin? *

YESNO
Present Grade * Insert an “x” under the grade and note the number of students

6th7th8th9th10th11th12thspecial EDOther
Name of person completing Enrollment Application *

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SCHOOL INFORMATION) Does the student have a sibling or siblings currently interested in attending Florida Metropolitan Transitional Academy?

YESNO
Type of Scholarship (attach affidavit and/or form):

Florida Tax CreditFamily Empowerment/Family Empowerment-Unique AbilitiesHopeParent fundedOther
Campus for which you are applying *

Broward County CampusSeminoleOrangePalm BeachHillsboroughMiami Dade
Year for which you are applying

2023-20242024-2025
How did you hear about Florida Metropolitan Transitional Academy Charter School?

FacebookWebsiteWord of MouthEmailOther
Did you submit the following? (Note: Applications cannot be considered for admission without valid copies of the following information attached to the application)

BIRTH CERTIFICATEIMMUNIZATION RECORDSOCIAL SECURITY CARDCOPY OF INDIVIDUALIZED EDUCATION PLAN(IEP), INDIVIDUALIZED TRANSITION PLAN (ITP)FUNCTIONAL ASSESSMENT (if applicable)ATTENDANCE RECORDS (Current and previous years)LAST PROGRESS REPORTLAST REPORT CARD ISSUED (if applicable)PARENT AFFIDAVIT/SCHOLARSHIP AUTHORIZATION
Student Signature

Clear
Date

MonthDayYear
Date
Parent/Guardian Signature

Clear
Date

MonthDayYear
Date
E-mail*
example@example.com
Facebook ID
Instagram/Snapchat/Twitter
Email Sender
Should be Empty:

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Registration Form