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Level's Business and Technology Academy Enrollment Application
Child's Name
*
First Name
Last Name
Child's Birth Date:
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
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Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
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2015
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Year
Address:
Street Address
Street Address Line 2
City
State
Zip Code
Child's Previous School Name
School Name
Child's Teacher's Name
Mr.
Mrs.
Prefix
First Name
Last Name
Child's Current Grade for 24-25 School Year
Grade
Mother's/Guardian's Name
First Name
Last Name
Mother's/Guardian's Cell Phone Number:
Format: (000) 000-0000.
Mother's/Guardian's E-mail
example@example.com
Father's/Guardian's Name
First Name
Last Name
Father's/Guardian's Cell Phone Number:
Format: (000) 000-0000.
Father's/Guardian's E-mail
example@example.com
Family's Church
Church
Are there any security/custody issues with this child?
*
Please Select
NO
YES
If you answered "YES" to the question above, please help us to know the security/custody issues for the safety of your child.
Security/Custody Issues
Does the child have any special needs (Speech, Occupational, ADHD, ADD, Asperger’s, Dyslexia, etc.)
*
Please Select
NO
YES
If you answered "YES" to the question above, please list the special needs of the child. (ADD, Asperger’s, Dyslexia, etc.)
Special Needs
Does your child have any allergies? (peanuts, chocolate, etc.)
*
Please Select
NO
YES
If you answered "YES" to the question above, please list your child's allergies.
Allergies
Emergency Contact #1
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Emergency Contact #2
First Name
Last Name
Phone Number
Format: (000) 000-0000.
In addition to those listed above (Guardian, Parents, & Emergency Contacts), please list the individuals who are also allowed to pick up your child from school.
Allowed to pick up child.
Please list any individual who is NOT allowed to pick up your child from school.
NOT Allowed to pick up child.
My child will get home by:
*
Parent pick up at 2:30pm.
Afterschool Program (Paid options)
I release Level's Academy to take pictures and video of my child, which will be used for media and marketing purposes.
*
yes
no
What are your educational goals for your child?
*
Enter step up for students Award ID#
*
If an emergency takes place I release Level's Academy to contact the nearest hospital on my child's behalf.
*
I agree
I understand Level's Business and Technology Academy is a Faith-Based School. I understand by enrolling my child into Level's Academy they will participate in prayer and reading the Bible weekly.
*
I understand
I understand Level's Academy is a Florida Approved Private School and the tuition for this school can be covered with the Step Up for Students Scholarship. I understand once enrolled I am responsible for providing Level's Academy with all correspondences needed from Step up for Students for my child.
*
I understand and I agree
Please up load physical and shot records ( For Kindergarten Only)
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File Upload for Previous Grade and Test Scores
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Submit Application
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