Evergreen Learning Collective Application

Evergreen Learning Collective Application

Please fill out the form below to apply for our hybrid microschool.
Student Name*

First NameLast Name
Student Date of Birth*
Student Grade Level in 2026/2027 School Year*
Parent Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Residential Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
What is your child's educational background?
Why are you interested in ELC/What are you looking for in a learning environment?
YesNo
If Yes, please explain.
YesNo
If Yes, please describe your availability and area(s) of interest.
Additional Information or Questions?
Should be Empty: