PCA Initial Application 24-25

2024-2025

Grades K-8

Initial Application

Parrish Charter Academy

8625 Erie Road

Parrish, FL, 34219

Phone: (941)545-6380

Email: office@pcaedu.org

Web: www.pcaedu.org
Enrollment Periods:

December 1, 2023 – December 31, 2024

January 1, 2024 – January 31, 2024

February 1, 2024 – February 28, 2024

March 1, 2024 – March 31, 2024

April 1, 2024 - April 30, 2024

May 1, 2024 – May 31, 2024
Student Information

Please submit one application per student.
Student Last Name:*
Student First Name:*
Student Middle Name:
Grade for 2024-2025 School Year*
Currently Enrolled PCA Sibling?*

YesNo
Current PCA Sibling Name?
Student Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Gender:*

MaleFemale
Student Date of Birth*

MonthDayYear
Last School Attended
Previous School:
Name of Previous School
City of Previous School
State/Country of Previous School
Parent/Guardian Contact Information
Mother/Guardian
Mother/Guardian Last Name*
Mother/Guardian First Name*
Mother/Guardian Email*
Mother/Guardian Cell Phone*
Please enter a valid phone number.
Mother/Guardian Home Phone*
Please enter a valid phone number.
Mother/Guardian Work Phone
If applicable.
Father/Guardian
Father/Guardian Last Name*
Father/Guardian First Name*
Father/Guardian Email*
Father/Guardian Cell Phone*
Please enter a valid phone number.
Father/Guardian Home Phone*
Please enter a valid phone number.
Father/Guardian Work Phone
If applicable.
How Did You Hear About PCA?*

OnlineAdvertisementFamily/FriendMailerFacebookEventOther
If "Other," Please Explain.
Name of Referring Family (if applicable)
I certify that the above enrollment information is true and accurate to the best of my knowledge.
Printed Name of Parent/Guardian*
Relationship to Student
Date

MonthDayYear
Thank you for choosing Parrish Charter Academy!
Should be Empty:

Student Information

Last School Attended

Parent/Guardian Contact Information