School Registration Form

Welcome to AGCC!
Thank you for your interest in joining our online learning community!

This application form is designed to help us get to know your child and ensure we provide the best possible learning experience. Please take a few minutes to complete all sections carefully.

If you have any questions while filling out the form, feel free to contact us at info@agcc.org or call us at 954-839-7502.

We’re excited to learn more about your child and look forward to partnering with you in their educational journey!

Let’s get started!

First you will tell us a little about your scholar

Student Name

First NameLast Name

Sex of student

MaleFemale

Age of child

Birth Date

MonthDayYear

Gender

State of Origin Ethnicity

In this section, share a little about your child's academic journey

Which School is your child currently enrolled in?

Date of resumption for school

MonthDayYear
Date
Date of closure for school

MonthDayYear
Date

Currently grade level of child

Please one report card within the last 3 years

Cancelof

Which of AGCC's program are you interested in?

AGCC After School ProgramAGCC Weekend AcademyAGCC College Diploma

Preferred days for online session

How would your describe your child's Math Skills

How would your describe your child's Reading Skills

Does your child have access to stable internet

YesNo

Does your child have access to a computer or tablet?

YesNo

Select the following requirements that apply to your child

Basic computer knowledgeHeadphonesQuiet and distraction free environmentBasic Typing skillsSkills operating the Zoom Platform

This page is decicated to contacting parental information
Parent Information
Parent Namen 1

First NameLast Name
Parent Name 2

First NameLast Name
Home Phone Number

Area CodePhone Number
Email
example@example.com

Please schedule a virtual meeting chat with our school leaders
Appointment

Registration Fee

Thank you for completing the application. A one-time, non-refundable registration fee of $50 is required to process your application. Once your payment and form are received, our admissions team will contact you with the next steps

Please complete payment to continue

Registration Fee Product Image

Registration Fee

$50.00 Quantity

Total

$0.00

Credit Card

Should be Empty: