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Sheridan Academy for Young Leaders
Application Form
Child's Name
First Name
Last Name
Address:
Street Address
Street Address Line 2
City
State
Zip Code
Grade You Are Registering Your Child For
Grade
Mother's/Guardian's Name
First Name
Last Name
Mother's/Guardian's Cell Phone Number:
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:
Father's/Guardian's E-mail
example@example.com
Does the child have any special needs (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
Submit Application
Should be Empty: