NEW CLC Enrollment Form:

CLC Enrollment Form

Thank you for your interest in CLC
Please sign-up via our new enrollment form here:

https://clcsummit.app.neoncrm.com/forms/enrollment-form-1
Parent & Student Information:
Student Legal Name

First NameLast Name
Has your student attended CLC in the past 3 years

Other
Student Preferred Name
Student Preferred Pronouns (Optional)
Student Date of Birth

MonthDayYear
Date
What year is your child expected to graduate highschool?
(Optional) Does your child have any allergies, medical conditions, or special needs we should be aware of to ensure their safety and comfort?
Parent/Legal Guardian Name

First NameLast Name
Parent Email (This is how we will send scheduling information and Invoices)
example@example.com
Phone Number

Area CodePhone Number
Preferred Method of Communication

Other
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Optional: Add additional Parent/Guardian
Would you like both parents/guardians to receive all email communications?

If your student has an IEP or 504 plan please fill out this page:

If your student does not have an IEP or 504 you can skip this page
My student has:
Upload Plan here (if finalized)

Browse Files

Cancelof
Is there anything else you would like us to know about your student's IEP or 504 plan?

Demographics

This information helps us better understand the communities we serve (e.g., grant reporting, tailoring services, and demographic tracking) Providing this information is optional.
Please select the race/ethnicity that best describes your child.

Other
Does your family receive or qualify for reduced or free lunches?

CLC Enrollment Form