Enrollment Interest Form
Student Name
*
First Name
Last Name
Student Email
*
example@example.com
Current Grade Level in High School
*
10th
11th
Current High School (Homeschoolers can enter "Home School")
Core Credits Completed At Time of Application
*
0.5
1.0
1.5
2.0
More than 2.0
I don't know
English/Language Arts
Math
Science
Social Studies
Physical Education
Health
Pathway Registration - Which Pathway would you like to enroll? Must choose at least one. If you're waitlisted in your 1st Choice, you could accept enrollment into your 2nd or 3rd choice if space is available. (Only one choice is required, but you can rank two or three)
*
1st Choice
2nd Choice
3rd Choice
4th Choice
Precision Machining/CNC
Welding
Building Trades/Heating & Cooling
Industrial Maintenance (beginning 2025-2026)
Parent/Guardian #1 Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Parent/Guardian #2 Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Household Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is your household residence in the Cedar Grove-Belgium School District?
*
Yes
No
Have any siblings from this household ever been enrolled in Rocket Academy?
*
Yes
No
If a sibling has attended Rocket Academy, please list their full name(s).
I hereby certify that I am the parent or legal guardian of the student named above, and that all of the information given in this application is true to the best of my knowledge. Please type name to indicate certification.
*
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