Course Registration Form

Registration Form

Fill out the form carefully for registration
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent E-mail
example@example.com
Mobile Number
Previous School Attended
Applying for Grade
Is there any information about your child's learning needs or accommodations that would be valuable for the school to know?
Please list any sibling or relative that currently attends:
Please complete this online application with the most accurate information.

Once the application has been submitted, we will contact you with an invitation to interview and tour the academy.
Date

MonthDayYear
Date
Signature

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